The New Lobotomy

This Friday’s version of The New York Times had a front-page article that described the well being of two men. The first man was older and found “himself completely unable to wash himself or brush his teeth”, while the second was a teenage who had “become so terrified of germs that he would regularly shower for seven hours”. These OCD patients both decided to undergo an experimental surgery that would, idealistically, allow them to overcome their disorder. This surgery requires that “four raisin-sized holes” would be “burned deep in their brains”. 24 months after the surgery, the first man insists that there was no change in his behavior as he “still doesn’t leave the house”. The second subject, however since the surgery, has been able to return to a “normal” life and is even able to attend college. This modern day lobotomy immediately evokes a comparison to One Flew Over the Cuckoo’s Nest. He argument over this procedure lies within the risk. Some medical ethicists still believe the results are hugely unpredictable. The Times explains, “It was not so long ago…that doctors considered the frontal lobotomy a major advance- only to learn the operation left thousands of patients with irreversible brain damage”. So far this experimental surgery is exercise for only extreme untreatable cases of OCD (5- 15 percent of OCD patients qualify). I believe that we need to make the distinction between progress toward a solution and deeming this surgery a solution. Careful research should continue, while only using this treatment on very drastic cases. It is our nature to desire to help everyone in need immediately, but we are not fully aware of the repercussions. We must recognize this step in the right direct, but not deem it the end of our journey to help these people.


Thanks to: Surgery for Mental Ills Offers Hope and Risk by Benedict Carey The New York Times

PGD Testing - Selecting healthy embryos

Recently, specialists have been able to use pre-implantation genetic diagnosis to implant healthy embryos into the womb and discard the embryos which are damaged. Experts believe that this genetic screening of embryos could eventually eliminate diseases such as breast cancer and cystic fibrosis. However, this prospect worries many ethicists. Bernadette Tobin, an ethicist at Australian Catholic University, was quoted in the article saying that selecting some embryos while rejecting others is a morally unacceptable way of avoiding having a child with a serious disease. Furthermore, discarding embryos with certain diseases creates a slippery slope. Sydney IVF medical director Dr. Mark Bowman says that they "are testing for serious genetic diseases." But, who's to say where a disease stops being "serious" and becomes "mild." By allowing this kind of embryo selection parents will start discarding possible children in search of that perfect embryo with no setbacks whatsoever. Eventually, this process could lead to an experience in which parents line up their embryos and select the best one from the bunch, much like one shops in the mall or the supermarket. Though this is probably not reasonable at the moment because we do not know the functions of all of the genes, it is certainly possible that one day it could be a reality.

I do understand that the main goal of this testing is to prevent children being born with incredibly painful and challenging lifelong diseases. However, another objection to this type of selection is that people will almost always choose to throw out the embryos with genetic "malfunctions" and we will start to see a decline or even lose much of the disabled population. This genocide of sorts against the disabled is also unethical. They should have just as much of a right to survive as perfectly healthy children do. There is no reason that a child with a severe disability cannot live a worthwhile life.

Instead of rejecting embryos because of an undesirable genetic trait, we should strive to create cures for diseases so that when a person with a serious illness chooses, they will be able to reduce the suffering or improve their condition. They should be allowed to live and subsequently, they should be given the choice to live with their disease or to use the cure. It is not our jobs to play God and choose which embryos gets to develop and which get put in the trash.

Relevant site: http://www.theage.com.au/lifestyle/lifematters/designing-principles-at-birth-of-a-new-era-20091121-is43.html

A New Form of Psychiatry

A new cure for obsessive compulsive disorder, depression, Tourette’s syndrome, and maybe even obesity may have been found, but not in the form of any drug. Instead, patients with severe cases of obsessive compulsive disorder have turned to brain surgery. A new technique of psychosurgery, called cingulotomy, surgeons can thread wires into a circuit connecting the regions of the brain processing emotions to the frontal cortex. This circuit appears to be overactive in patients with OCD, and the surgery can help relax the patients. Other surgeries can stimulate the brain by providing more or less electric current to certain areas of the brain, while others burn out sections of certain brain circuits associated with a particular disease.
So far, only patients who meet strict criteria have been permitted to undergo this surgery (such as a boy who spent seven hours a day in the shower or a man who refused to wash himself). In some cases it has been successful while some surgeries have not created much of a change. Patients have to undergo strict screening and many are turned down if their symptoms are not disabling enough. Now the surgery is used as a last resort for patients who have tried everything else, with the understanding that it may or may not be successful.
This surgery can provide relief to severely affected people, but we still do not know enough about the brain to promise a positive outcome. We are essentially tampering with these patients’ brains and rewiring parts of their minds. At the moment it is in its experimental stages, but once scientists have learned enough to promise success, how will we determine who is disabled enough to undergo treatment? So far, obsessive compulsive disorder has been the most common cause of surgery, but anxiety, depression, and obesity have also been mentioned as “diseases” that may be cured. However, there is no marker that specifically defines someone as anxious. Eventually, will healthy people look to have their brains stimulated to help them relax more, concentrate better, or otherwise enhance their minds? It makes sense to help people whose day-to-day lives are severely affected by their mental disorders, but we need to make sure that these surgeries to do not cross over the line separating treatment and enhancement, no matter how tempting may be.

Article Relevant to my Post:
"Brain Power--New Techniques in Brain Surgery Mix Hope with Risk" by Benedict Carey
http://www.nytimes.com/2009/11/27/health/research/27brain.html?_r=1&ref=health&pagewanted=all

To Decide or Not to Decide

When I was researching a topic for the third essay, I came across the ethical dilemma of whether teenagers should be able to make decisions in the context of life-altering situations such as surgery or the refusal of certain medical treatments. A teenager under 18 is not legally in charge of his or her own medical care, but the question is should they be able to make their own decisions? There is a very arbitrary line drawn at the age of 18 when an individual is suddenly capable of legally making all the decisions in his or her life. Ironically, the day before your 18th birthday you need parental consent and are considered incapable of these same decision making processes? A better judge of capability is the level of maturity of such an individual, because it is quite clear from everyday experience that some individuals are mature beyond their years, and just as many are the opposite; they are extremely immature.

One example comes to us from Britain, where a 13-year-old girl decided to refuse a life saving heart transplant. Understandably, this worried a few of her doctors and outside observers. They said she was making a rash decision and that she did not have enough life experience to know what was truly good for her. However, she had thoroughly thought about the surgery and decided that one more surgery would only prolong her life a little longer before she needed another one too. Also, she wanted to spend time with her family instead of in a hospital and believed she would be saving the life of another patient who needed a heart transplant. Her rational, logical argument and contemplation convinced the lawyers and the local child service agent as well as a good number of those who learned of her story. This rational and convincing logic is a sign of maturity, and teenagers who can make decisions in this fashion seem to be capable of choosing what is best for them. However, these teenagers still lack the degree of knowledge their parents and doctors have, so the question remains, who makes the decision in these cases?

Souces Relevant to my post:
“Teenagers and the right to be wrong” by Dominic Wilkinson
November 14, 2008 on the website Practical Ethics: Ethical Perspectives in the News

“Hannah's Choice: Saying No to a New Heart” by Nancy Gibbs.
Thursday, Nov. 13, 2008 in Time.com

The Perfect Egg Donor

Recently, as I was browsing Facebook, I stumbled upon an advertisement requesting egg donors. With curiosity heightened by our studies of human experimentation, I followed the link to EliteEggDonors.com. The site was offering $75000 to donors with the specific characteristics that Preferred Donors must have. Among these characteristics were: at least 5’8, athletic—“college or professional level”, very attractive--“Modeling experience a plus,” genetically healthy, and “proven intelligence.” While I could understand how future parents seeking a donor would want to reduce the number of problems their child may have and thus request the best possible donors, I was struck by the requirements of being “very attractive,” having “proven intelligence,” and being “athletic.” While I thought that egg banks coul offer help and support to couples that cannot successfully produce a child, and understood that the banks often go through a rigorous way of appropriately matching eggs and parents, I was initially skeptical of an egg bank requesting such “perfect” eggs. However, I realized that unlike designing children, egg donation is a way of resolving the problem of infertility, rather than seeking enhancement.

If an increasing number of humans began to use the eggs of, in their opinion, the most ideal or perfect person, diversity would probably begin to decline, and people may begin to follow trends in character, rather than accepting differences. While the comparison may be a stretch, the type of eggs in demand may follow a pattern similar to that of clothing—one “style” is in demand, but only a few months or years later, and a whole new “style” becomes popular. Looking at it from an economical perspective, the value of model-like looks, for example, or athletic ability would go down because almost everyone would embody those qualities. Long-term, people would become similar, which could have an array of social and perhaps even psychological consequences, such as devaluation of those without those qualities, inability to accept imperfection, and the like.

While these issues would become a concern if people turned to egg donation and in vitro fertilization as a primary means to choose their child’s characteristics, social chaos could ensue. However, egg banks really only appeal to those who physically cannot conceive or produce children, because in general, people want to have children of their own, with a genetic makeup derived from their own. Egg banks also tend to only offer their service as a solution for couples with existing procreative limitations, so it egg donation and usage can be placed in the realm of therapy, while it is not necessarily therapy by definition. Therefore, since egg banks serve those with reproductive disabilities, egg donation is ethical. Also, in order to reduce emotional complications for the family and the child, choosing children with favorable traits is in the favor of the entire family. In order to reduce unfavorable genetic tendencies that could cause more emotional duress, egg banks request those with the most preferable traits, so as to ensure, as best as possible, family contentment.

EliteEggDonors.com

www.northshorelijivf.com/donor-egg-program-long-island/donor-egg-faq-recipient.html

How Is This Cosmetic?

As I sat in my car on the ride home from the doctors office I was faced with a decision to make: do I get surgery so I can pursue my athletic career or do I not get surgery and be content with my decision that I will never be able to run without pain again; moreover, I may have to quit the sport I love? Tears streamed down my face. Having surgery meant having 5-inch scars on both sides of both of my legs for the rest of my life as reminders of what I did so I could be able to play college lacrosse. Not getting surgery meant quitting the sport that ultimately made my decision of what college I ended up going to and was the sport that was responsible of some of the greatest times of my life so far.

My dad turns and looks at me and says “Ultimately your surgery is a cosmetic surgery.” Obviously I was confused. It wasn’t like I was getting a nose job or breast implants. The doctor would remove tissue from my legs in order for my muscles to expand more and so I could run without pain or numbness. How is that considered cosmetic? But then I thought the situation over and realized that this surgery wasn’t necessary. My life wasn’t in jeopardy if I didn’t receive the surgery. However, in my mind, receiving surgery seemed like the only option. I love lacrosse, and if the only way I could continue to play was to receive surgery, I was going to get the surgery. But to outsiders, including my parents, surgery was just a huge step to take just so I could play a sport, moreover, and optional sport.

Although I may consider my sport part of my life and huge part of shaping me into who I have become today, my sport does not define me. I would be receiving surgery so I could play something for 4 years and then my career would be over since there is no women’s professional lacrosse. I was stuck. Of course I wanted to play lacrosse, but surgery was such a drastic step to take. Was I mature and willing enough to accept that step, for better or for worse, and accept that I may regret it in the future?

I ended up going through with the “cosmetic surgery.” Currently I have 40 plus stitches in my legs. My legs are swollen and I’ve been so doped up on medication I can’t even watch tv. But in my mind, it was all worth it. Some people look at my parents and me and think we are crazy. They question my parent’s moral. How could they let their 18-year-old daughter go through surgery so she could play a sport especially if the surgery wasn’t even necessary? It’s because they love me and love me enough to let me strive at the thing I love. Sure, I may regret this surgery in the future, I may be angry with my parents that they allowed me to have it, or I may be mad at myself that I let myself get lost so lost in a sport that I was willing to put my life as risk to be able to play at a higher level. But for now, knowing that I will have the ability to play at a level I know I can play at pain free is all the motivation I need to get me through this. I couldn’t be happier with my decision and I am looking forward to making great progress with my new legs. Whether this surgery was an enhancement is a whole other story that only time will be able to tell.

Paralyzed But Conscious For 23 Years

Three years ago, a Belgian man who had been assumed to be in a coma since 1983 was found to be completely paralyzed, but completely conscious. Entirely unable to communicate, Rom Houben, 46, was believed to be in a persistent vegetative state until examination using (unspecified) "a state-of-the-art scanning system" as part of a larger study of coma patients revealed that his brain was functioning normally. Since then, he has been able, through intense physical therapy, been able to regain a modicum of control, and can now speak via typing with one finger on a computer keyboard.

This admittedly staggering news story brings with it a degree of sensationalism. To American minds, it is most strongly reminiscent of the national imbroglio that was the Terri Schiavo case, which culminated in 2005 with her removal from life support. Indeed, the neurologist who discovered Houben's brain activity, Steven Laureys, acted as an adviser for that case.

Had Houben, like Schiavo, been removed from life support, his doctors would have unknowingly murdered him. This is especially chilling when one considers Laureys's assertion that misdiagnosis occurs in coma cases "on a disturbingly regular basis."

Yet Houben's family had taken him to the United States for reexamination five times; not until twenty three years into his "coma" was his consciousness able to be diagnosed. Were he removed from life support several years before this discovery came about, it would be tragic, yes, but not retroactively unethical. The curse of medical technology is that each advance brings with it the burden of hindsight; had we been able to transplant a particular organ a year before, Patient X may not have died on the table. What we now know casts a new light on cases of the past, but does not and cannot revise them. We cannot fault those who pulled the plugs for not knowing what they could not have known.

Relevant sites:
"Trapped In His Body For 23 Years" - The Guardian UK

Medical Marijuana: An Issue of Regulation

In 1996 California passed a law that legalized medical marijuana use. Unlike in the laws of the twelve other states that followed California in legalizing marijuana use, California’s law is very open, allowing marijuana to be used “for any illness for which marijuana provided relief.” In effect, this has allowed doctors to “recommend” marijuana (they are not allowed to “prescribe” it under the law) to anybody they see fit. In past years, this has increasingly begun to include adolescents with ADD and ADHD.

 While I have not systematically gone through the literature on the linked between marijuana use and ADD/ADHD, neither the New York Times article that I read nor a search on google scholar with the search term “marijuana ADHD” revealed any studies examining the use of marijuana for treatment of these disorders. Thus, it appears that any “proof” that marijuana is or is not effective in treating ADD and ADHD is purely anecdotal.

 I am not against marijuana use as long as a proper risk-benefit analysis has been conducted and it has been concluded that the benefits outweigh the risks. However, in this case, it does not appear that any proper medical study has been carried out. Some doctors anecdotally swear that marijuana use has allowed ADD and ADHD symptoms in a few of their patients to wane, while other doctors insist that marijuana only serves to disrupt attention and concentration, problems that those with these disorders already must grapple with. In addition, without further research, it would seem that the default should be to steer away from prescribing marijuana as the currently available research does suggest that marijuana can cause dependency and significant long-term problems.

While some oppose marijuana use on ethical grounds stemming from the fact that it is illegal etc, I believe that marijuana should be treated as any other medicine is: put through rigorous medical trials to determine if it is appropriate to use it for various different illnesses and disorders. It seems unacceptable to me that California has allowed doctors such free-license with recommending marijuana to patients when it would seem that other medicines are regulated much more carefully.  

Related Links:

Ellison, Katherine. "Medical Marijuana - No Longer Just for Adults." New York Times. 21 Nov. 2009. 

The Ethics of Psychology

Psychology experiments are aimed at investigating and delving into the inner mind and understanding the way we think. These are a crucial part of learning how people interact with each other, the way we influence one another, and the way we view and perceive our everyday surroundings. But what happens when these experiments go too far? When the focus on scientific knowledge overshadows the well being of the participants?

There are numerous examples of studies, mainly conducted before the advent of ethical standards and guidelines that have subjected the participants to undue amounts of stress or without consent that were clearly unethical. One example was a study by John Watson in 1920 involving a participant nicknamed Little Albert. Watson chose Albert to participate in a study to determine if fear could be conditioned and expand upon the idea of classical conditioning. Albert was subsequently presented with a white rabbit, a white rat, a monkey, a mask with hair, a mask without hair, cotton wool, burning newspaper and various other stimuli. Albert was placed in a room and given a white rat to play with. He did not show any initial fear of the rat, but afterwards Watson began to strike a steel bar every time Albert touched the rat after that. When Albert was later presented with the rat or other objects that reminded him of the rat, he began to cry. Watson had successfully cultivated a fear of the rat, white objects such as the rabbit, and furry objects such as cotton wool. Watson never desensitized Albert though or tried to dissipate the newly formed fear that Albert had developed.

The “Little Albert” study has become one of psychology’s more important studies involving conditioning, but its ethics are extremely questionable. Little Albert did not consent or assent to participate in the study, his legal guardians were not fully informed of the experiment, and lastly he was intentionally scared over and over again. Experiments like this are not permissible in today’s society, and new ethical guidelines help protect participants in experiments by providing review boards to ensure that the benefits outweigh the risks and that the subject has given consent to the experiments, however, unethical studies such as the Little Albert study continue to influence psychology today.

Websites Relevant to my post:

http://www.psychology.sbc.edu/Little%20Albert.htm

Reflection on potential harm of genetic engineering

As I read the Sandel article “The Case Against Perfection” for the fifth time to find a good quote, I reached a state that if I were woken up at 4am from sleep and asked on what moral aspects would genetic engineering do harm to humans, I could answer: humility, responsibility, and solidarity without thinking. I guess it is probably true for most of our writing seminar class.
After the three words got so ingrained into my brain, I wondered if there’s any other major harm the whole “drive to mastery” attitude can bring. Finally I came up with one reasonable enough, and I’ll just throw it out here. (I’m sure there must be some sociology name for it, but due to my obliviousness I just don’t know until someone tells me.)
One objection Dan raised in class about Annie’s thought is that implanting chips into brains is expensive, and if anyone’s getting it, it would probably be the rich first until it’s so common one day it’s just one item in the supermarket. This is why many people argue that two human species would be created: one superior kind with perfect attributes and one inferior kind whose opportunities are limited to what the better kind overlooks.
The sub-species theory deserves serious concern because not only is it unequal, but also it suppresses the occurrence of human genius, especially those from the grassroots of a society. Nowadays the gap between the rich and the poor is probably bigger than ever, but people still believe in “Slumdog Millionaire” phenomena. It is possible that a person from an adverse, or unfavorable, environment can still reach great achievements with talent and efforts. In the genetic recombination game we humans don’t play god yet. However, imagine one day the rich get to make sure prenatally that their offspring are talented. It would create such high obstacle for the disadvantaged to catch up through endeavor that the motivation to work hard may decrease. The society as a whole suffers because potential of an ingenious idea is priceless, and there is no guarantee from whom valuable inventions will come from.

Thanks to,
Sandel, Michael J. “The Case Against Perfection.” The Atlantic Online. April 2004. Web. 2 Nov. 2009.

The Length of Duty

Surgeons and scientists may have reached a breakthrough with glioblastoma, a malignant brain tumor (the same as the one that killed Senator Edward Kennedy), and according to Dr. Russell Lonser of NIH “one of the most deadly tumors that exist in humans.” Although still in the trial stage, neurosurgeons have found a way to directly release a cancer drug into the brain and onto these malignant tumors. Using microcatheters, doctors can bypass the blood-brain barrier and release the chemotherapy to directly target the tumors. However, this was a dangerous experiment, as the drug, called Avastin, could have caused swelling in the brain, a hemorrhage, or a seizure.
In an article by the New York Times, Dennis Sugrue was featured as the second person to have had Avastin injected directly into his brain. Despite the dangers of the experimental drug, he agreed to go through with the clinical trial, which has so far been successful. But despite the success and positive direction of the trial currently, there was much more to his decision to participate in the trial. As columnist Denis Grady writes, doctors must “balance their ambition as researchers against their duty as clinicians, and must walk a fine line between offering too much hope and not enough.” Also, according to the guidelines drafted in the Belmont Report, doctors must provide their patients with enough information to allow them to make in informed decision. However, in the actual report, this is all a little vague—how much information is enough? Dr. Boockvar, Dennis Sugrue’s surgeon, answers this question for us: “In neurosurgery they say that if you don’t make your patient cry, you haven’t gotten informed consent.”
After reading this quotation, I began to think about the duty that doctors (neurosurgeons in this case) have to their patients undergoing trials. Just as Grady writes, they must realize that they must protect their patients in addition to aspiring to find the next cure. It may be hard to be completely truthful when on the brink of a huge breakthrough such as a cure for cancer, but doctors must provide their patients with all the information they have. And in neurosurgery, it will be enough to make them cry.

Articles Relevant to my Post:
http://www.nytimes.com/2009/11/17/health/17tumor.html?pagewanted=2&_r=1&ref=health

Cause for Gene Therapy Hope

As I wrote in my essay about Ashley's Treatment, my younger brother was diagnosed with Duchenne's Muscular Dystrophy when he was in first grade. Since then, my parents have taken steps in order to maintain the strength of his muscles for as long as possible. My brother goes to physical therapy once a week and is also taking steroids. As a result of the treatment, my brother is still able to function normally, in that he is still able to walk and do things for himself, though not as easily as he once could. The only side effects of the treatment are quick mood swings, an increased appetite, and a reduction in his growth. None of these side effects are life threatening in the least and so the benefits of his treatment greatly outweigh the risks.

Recently, Janaiah Kota and some colleagues from the Center for Gene Therapy at Nationwide Children's Hospital in Columbus, Ohio engineered a virus which when injected into monkeys increased the monkeys' strength and also stopped the breakdown of muscle which is the main problem with my brother's disease. While this research is very promising and gives me hope that my brother one day may be able to lead a normal life, there are still risks with gene therapy which cannot be overlooked. The monkeys did not have a degenerative muscle disease and it is not known if this treatment will have any adverse effects in humans. If there is more research done on human subjects which still shows results without harmful risks, then I believe it could be considered an option for my brother. However, at the moment, my brother is young and enjoying life. Even though he cannot participate in certain activities, he finds things that make him happy and he is one of the funniest people I know. I would not want my brother to be another newspaper headline for the risks associated with gene therapy. Although I think gene therapy might ultimately help cure my brother of his disease, the unknown risks at the moment are too high. Hopefully this exciting development will progress quickly so that one day my brother will be able to enjoy a limitless life.

Relevant site: http://www.reuters.com/article/scienceNews/idUSTRE5AA3ZY20091111?feedType=RSS&feedName=scienceNews&rpc=69

Hidden Agendas for Abortions

Prenatal genetic testing has become a very alarming subject to autistic and down-syndrome communities. Genetic testing involves several laboratory procedures that allow families to receive information on their baby before it is born. These procedures can conclude the possibility of an individual developing certain diseases based on their genetic makeup. Particular communities fear strongly the information discovered in these tests will be used to distinguish the “weak” from the “healthy” babies. Due to this massive fear, people openly oppose these experiments. Asch mentions in his article Prenatal Diagnosis and Selective Abortion: A Challenge to Practice and Policy “that opposition towards prenatal testing and selective abortion comes from the conviction that life with disability is worthwhile and the belief that a just society must appreciate and nurture the lives of all people” (db.jhuccp.org).
I believe that the tests can be powerfully beneficial as long as they are not used to determine whether abortion should be considered. There value should be recognized. One mother explained in Epinion her personal pregnancy story regarding her disabled son and verbalizes, "I would ask you to at least consider the benefits of prenatal testing. Knowledge is indeed power. By knowing about potential problems, you give your child the best chance at a safe and healthy delivery and start in life” (Prenatal Testing Is Not About Abortion). While genetic testing can often ease the minds of families, extreme caution must be exercised.
Susan M. Wolf’s book Feminism and Bioethics: Beyond Reproduction concluded through research in Korea that the country is currently anticipating in the next thirty years a ten percent increase in the male to female ration. Tim Friesen explains, “Sex selection is illegal in Korea but doctors give unspoken results through the amount of enthusiasm they show the mothers. If the doctor lacks enthusiasm upon the test results, the mother often calls for an abortion, knowing that the fetus is a female” (ndsu.nodak.edu). The situation in Korea demonstrates the lurking issue. Sex selection can frequently be masked by other reasons for abortions. The reasons for abortions must be carefully monitored as to ensure the future of the human race.

Thanks to:
-Prenatal Testing Is Not About Abortion (http://www99.epinions.com/content_3993215108)
-http://db.jhuccp.org/ics-wpd/exec/icswppro.dll?BU=http://db.jhuccp.org/ics-wpd/exec/icswppro.dll&QF0=DocNo&QI0=145660&TN=Popline&AC=QBE_QUERY&MR=30%25DL=1&&RL=1&&RF=LongRecordDisplay&DF=LongRecordDisplay
-http://www.ndsu.nodak.edu/instruct/mcclean/plsc431/students/friesen.htm

Physicians and Cognitive Enhancing Drugs

While sleep deprivation fosters much college agony, it is also a serious issue in the medical field. Doctors that have to work many hours, and oftentimes late at night, have to stay on task every minute, because people’s very lives may be in their hands. As a result, some doctors turn to performance enhancing drugs, such as Vasopressin (2) —though this may be a more dangerous stimulant. Studies show that doctors who work longer hours tend to make more mistakes when working on a certain task (1). However, a physician’s job does not allow for many mistakes. In fact, one mistake could cost the life of a single patient. So is it unethical for doctor’s to take performance enhancing drugs? I think the answer to this is no, it is not unethical. Why? Because in taking these drugs, the doctor is helping a great number of people, and preventing mistakes in the procedures.

If an athlete were to take performance enhancing drugs, it may be considered unfair to his opponents, and if a student took performance enhancing drugs, his integrity may be put into question, but when a physician takes performance enhancing drugs, his motives tend to be different. Perhaps the doctor is in fact trying to get ahead of other doctors, but how would he be getting ahead? He would be helping other patients more effectively. Therefore, in striving to get ahead, he would really only be helping his patients. However, if the doctor’s motives are not to “get ahead” then they are probably to stay awake on the job, or to better help the patients. In order to do this, he may turn to mental stimulants, that keep him focused and on task. No matter what the doctor’s motives may be, if he takes drugs that keep him awake and concentrated, his performance on surgeries and procedures will be less prone to fault, thus benefiting all his patients.

While some people use enhancement drugs for their own profit and benefit, and theirs only, at least in a direct sense, when a doctor uses cognitive enhancing drugs while working many hours, he is profiting not only himself, but perhaps hundreds, if not thousands of patients by lowering the chances of mistakes (1). If sick patients are allowed to take enhancement drugs to for healing their ailments, then why can’t their doctor take performance enhancing drugs to heal their patients in a safer and less mistake ridden way? I think that yes, when doctors use cognitive enhancers it only benefits their patients, and is thus ethical.

(1) http://wellness.blogs.time.com/2009/10/13/for-doctors-less-sleep-not-long-hours-linked-with-more-mistakes/

(2) http://www.independent.co.uk/news/uk/smart-drugs-slip-through-gap-in-law-1531330.html

Experimental Gene Therapy: Improving The World You See

Imagine you were a young child sitting in class and you were the only one unable to see the board. You couldn’t see well enough to play baseball or go out to play hide-and-seek with your friends. This is how seven year-old Corey Haas had been living his life so far. As he has gotten older, his vision has worsened. Corey was expected to loose his sight all together. Fortunately for him, when he was eight years old he received an experimental gene therapy that was very successful. After this therapy he was able to participate in many activities that most kids his age did.

Corey had a virus injected into his left eye. The virus had the gene RPE65 inserted into its genome so that when it released the virus DNA into the eye cell’s DNA the RPE65 gene would also be taken in. This gene was critical in improving the eyesight of Corey and others who have had the same experimental treatment. It was given to a group of people who vary in age from Corey’s age to 44. All saw noticeable results, although the younger the patient, the better the results. One of the study leaders, Dr. Katherine High, thinks that it might be possible to give the experimental treatment to younger children (age three and eventually younger) and possibly at some point in both eyes.

There would be a lot of conflict regarding whether or not this therapy should be given to little children. Even though this gene therapy is experimental, it has a great affect on the patients it is given too. It would help a child lead a more normal and easier life. Even though this therapy does not create perfect vision, just that it helps clear up someone’s vision somewhat is helpful. Because this experimental therapy has seen quite a bit of success, I think it would be a good choice for some children with serious vision problems to undergo the therapy.

References:

http://www.nytimes.com/2009/11/03/health/03eye.html?_r=1&ref=research

An Increasingly Fine Line Between Medical and Non-Medical Treatments

Policy makers are struggling to keep up with the boom in recent years in cosmetic treatments such as liposuction, plastic surgery, and laser hair removal. While all of these treatments can have very real negative consequences, these treatments are as of yet not regulated in many states.

For example, in New York, anybody can provide laser hair removal treatment despite the fact that there have been multiple cases of second and third degree burns from unregulated and improper application of the treatment by self-proclaimed “professionals.”

In addition, medical spas across the country are increasingly offering invasive liposuction therapy and it is not uncommon to see walk-in Botox “clinics” in American malls. With news of the tragic death of a woman in Florida who passed away during liposuction surgery at a “medical” spa, the issue of regulation of these cosmetic treatments has again come to the fore.

I agree with the view that spa treatment should be limited to non-invasive massages and facials that allow customers to relax and pamper themselves. Any procedure that involves an operating table, anesthesia, lasers, or injections should be conducted in a medical environment with properly trained medical professionals, not at a mall kiosk or spa.

In addition, in the future, I would hope that regulatory bodies will take preemptive steps to regulate new medical technologies, not waiting for the alarm bells to ring after people have been harmed and even killed as a result of the lack of regulation.

Related links:

Sweeney, Camille. “Surgery at a Spa? Buyer Beware.” New York Times. 4 Nov. 2009. 

 

"For the Good of All Mankind"

According to Kant we are supposed to always treat others as a mean and not an end. However, the utilitarian says that the greatest good for the greatest number is exercising good morals. In applying both of these philosophical approaches to human experimentation we run into a few problems.
Dr. Henry K. Beecher reviewed cases of violating human dignity and stepping out of bounds in human experimentation and came to the conclusion that the worst transgressions occurred when the experiment sought to benefit society and not the individual patient. According to Beecher, problems arise when humans are used as an ends to further knowledge instead of their own health. For the most part human experimentation has focused more on using people as an ends instead of a means, but should this be the case? The utilitarian view is difficult to accept because the benefits are difficult to measure. They usually occur in the future and putting an exact value to them is nearly impossible. But does this mean that we should limit the number of experiments conducted for the betterment of mankind. In a previous blog post I spoke about the Stanford Prison Experiment. It had obviously negative ramifications for the participants and the original intentions of the experimenter were ambiguous, but it has benefited society in some capacity. The participants consented under their own will and understood that there could be negative consequences. The benefits could be recognized when prisons restructure themselves so that inmates do not suffer the same malicious behavior. The number of people it could help could be infinite. But are we supposed to not allow these controlled experiments to happen?
I absolutely think that there is a line in experimentation, but if informed and willing people participate in controlled experiments, can't the knowledge gained be worth the negative affects? It isn't true across the board, but it can be true in many situations.

Death Penalty Saves Lives?

According to approximately a dozen studies conducted by economists in the past decade, the death penalty saves lives. For each inmate executed, the studies indicate that three to eighteen murders are prevented.

The death penalty has always been a highly controversial topic. Advocates argue that execution will not only give members of the victims’ families a sense of justice and closure, but it will also prevent the convicted from harming his future victims. Opponents disagree, claiming that the death penalty is an ineffective way to deal with criminals; “an eye for an eye makes the whole world blind” while “two wrongs don’t make a right.”

There is no perfect solution to the death penalty. How do you comfort the victims’ family members? Do you tell them that the murderer will be dealt fair punishment for his actions, or do you tell them that the murderer is being allowed to live while their loved ones had to die? How do you face them after that? As a result, many people feel that the justice system does not do enough to protect the rights of the victims, and consequently, lose faith in the government. But how do you put an end to the vicious cycle that is murder? Do you have the right to control whether or not someone dies or lives? Who really has that right anyway? In a perfect world, no one would murder, and the issue of the death penalty would be resolved.

Cass R. Sunstein, a law professor at the University of Chicago, and Adrian Vermeule, a law professor at Harvard, both make a valid point when they point out that “capital punishment may well save lives. Those who object to capital punishment, and who do so in the name of protecting life, must come to terms with the possibility that the failure to inflict capital punishment will fail to protect life.”

Source: http://www.nytimes.com/2007/11/18/us/18deter.html?pagewanted=1&_r=1

Transgender Athletes

When it comes to the medical enhancement vs. surgical enhancement, there is a fine line. Essentially they both do the same thing, but one is viewed as legal while the other is not. How is it that it’s allowed to correct your vision to be more then perfect while it’s banned to make it so your muscles perform the best that they can? In my eyes, surgical enhancements are extremely similar to medical enhancements and many people reap the same benefits from surgical enhancements that they would from steroids. What makes athletes fall to the use of medical or surgical enhancements is the want to be better or the overall best. They will go to great lengths to do so. Some people even consider having a sex reassignment surgery to do so.

Transgender athletes are becoming more popular as the years go by. With sex reassignment surgery becoming more widely accepted and practiced, some athletes are willing to become another sex in order to excel in the sport that they love. Renee Richards (born Richard Raskind) underwent sex reassignment surgery in 1975. After doing so, U.S. Tennis Association banned her from competing in the U.S. Open. Many women were complaining that Richards would have an unfair physical advantage. When Richards took this case to court in 1977, the court sided with her. Richards then played for five years, won a singles title, and reached the quarterfinals in the 1978 U.S. Open (Hamilton). Had Richards remained a man, the opportunity to reach the U.S. Open would have never be possible for her.

However, some associations prohibit transgender athletes to take part in their competitions. In order to exclude transgender, associations put the phrase “female at birth” clause in their entry forms (Hamilton). The International Olympic Committee does allow athletes who have undergone sex-change surgery to participate in athletic competitions. Those athletes must have their surgery legally recognized and go “through a minimum two year period of postoperative hormone therapy”(Hamilton).

It’s amazing see the lengths some people will go to to achieve their dream of being the fastest or scoring the winning goal. I wouldn’t be willing to sacrifice my gender in order to win a medal but clearly there are those out there who are more then happy to do so. But is it right for someone to change who they were born to be just so they could compete in a different competition. Is having a sex change any different from taking a steroid? Over time, society will decide. For all we know, to make things fair between sexes, we may have to merge both sexes into one open division. Only time can tell the outcome of transgender athletes and the future that lies ahead of them.

thanks to: http://www.gymnica.upol.cz/index.php/gymnica/article/viewFile/74/68