Nanotechnology: There’s nothing Nano about it

Nanotechnology. The next big thing that could potentially completely revolutionize the industry. Governments are investing billions of dollars in the field of nanotechnology and scientists are predicting that it will take many different industries by storm. What exactly is this new phenomenon that is causing all this fuss?

Nanotechnology is the precise manipulation of materials and molecules at a whole new level – an extremely small, nanoscopic level. A nanometer is one-billionth of a meter. To put that into perspective,  “If a nanometer were somehow magnified to appear as long as the nose on your face… a human hair would be about two or three miles wide [and] one of your fingers would span the continental United States.” At a nanoscale, everyday, ordinary materials can have amazing, extraordinary properties. Furthermore, since nanotechnology allows us to manipulate atoms, the very building blocks of nature, this could give us the ability to create virtually anything.

Just think about the possibilities that could arise from this! We could create almost anything in a stronger, lighter and better form using even garbage! Certain diseases would be eliminated. Human life could be extended for hundreds of years, through cellular repair enabled by nanotechnology. Although research is only just beginning for this new field, the incredible predictions for what nanotechnology could accomplish have already been made.

We must, however, stop to think about the possible risks involved in this revolutionary technology. Imagine for a second, this immense power falling into the wrong hands. Not everyone in this world is working towards creating a better society and environment. Some could harness this power and create potentially horrific things. For example, atomic weapons could be made to be much more powerful and destructive. More importantly, they would be more accessible to all the wrong people. The idea of enabling terrorists to get their hands on such a deadly weapon is not one I would like to toy with.

While the development of nanotechnology has far-reaching, incredible and almost unimaginable benefits, one must also consider the immense risks that it brings. Will the government be able to regulate exactly who does what with this technology? Are the advances in society worth the potential destruction of it? With so many benefits and consequences to weigh, the controversy surrounding nanotechnology is perhaps something governments should consider more as they continue to invest huge sums of money in the field. Who knew that such a small thing could have such a massive impact?

http://www.rdmag.com/news/2013/01/study-explores-potential-benefits-threats-nanotechnology-research

Euthanasia: has it gone too far ahead? 

So what exactly is voluntary euthanasia and what are its different forms? Voluntary euthanasia refers to the killing of a person who has requested to be killed. It takes three forms: passive voluntary euthanasia, assisted suicide, and active voluntary euthanasia. Passive voluntary euthanasia is when the suffering person willingly stops receiving necessary care such as medicines, food, water, etc in order to cause his/her death. Assisted suicide is when the suffering person willingly commits a suicide using the information or the means provided to him/her by someone with the intention of helping the person to die (such as swallowing lethal tablets given by the doctor). Active voluntary euthanasia is when someone, on the suffering person's consent, explicitly performs an action that brings about the death of the suffering person (such as administering a lethal injection).

Passive voluntary euthanasia is legal throughout the United States of America. When it is not possible for the suffering person to give consent, passive voluntary euthanasia can be induced by the consent of the legal surrogate of the suffering person. However, it is disturbing to know that assisted suicide has been legalized in the states of Oregon, Washington and Montana. Even more disturbing is the fact that active voluntary euthanasia has been legalized in the countries of Belgium, Luxembourg and the Netherlands.

The reason I believe passive voluntary euthanasia is justified is because the suffering person is merely choosing what happens to him/her, and I believe that we all should have this freedom. However, legalizing assisted suicide or active voluntary euthanasia is essentially making terminally ill people 'vulnerable' to doctors. Some people might argue that these two forms of euthanasia are still voluntary and would happen only after the consent of the suffering person, but what they fail to realize is that this consent will be far from 'informed.' For an eighty year old terminally ill woman who can't even read and understand the morning newspaper, how do we expect her to understand the probabilities of all future improvements that might be possible in her health and then make a proper, calculated choice? Not every common man has the knowledge of medicine, and that makes him/her extremely vulnerable to doctors who might mis-advise them in order to reduce the financial risk of providing health care for terminally ill patients.

People who support these two forms of voluntary euthanasia see things as black and white, but that is hardly ever the case. Legalizing assisted suicide or active voluntary euthanasia will cause a slippery slope that will lead to suffering persons being psychologically and emotionally manipulated into making choices that might not be best for them. 

Sources: 

http://www.euthanasia.com/index.html

http://news.google.com/newspapers?id=qwgjAAAAIBAJ&sjid=jc4FAAAAIBAJ&pg=4910,299074&dq=karen-ann-quinlan&hl=en

http://www.lifesitenews.com/news/new-book-reveals-the-shocking-truth-about-euthanasia-and-assisted-suicide-i/

Forced DNR; Taking Patients off Life Support without Consent

Texas now has legislation in the works that would allow doctors to hypothetically place a DNR, or do not resuscitate, onto patients charts with out informing the patient or a surrogate to give doctors permission. This is the first piece of legislation of its kind and its goal is to lower the cost on the sate or hospital for patients who are going to die imminently. Unless explicitly stated doctors can put this DNR order on the charts of patients who are expected to die soon. This legislation is not meant to be applicable to patients who are going to die within month or weeks but only those who are going to die within days.

            The rational, as stated above, for this is to save money. The hospitals don’t want to pay to keep someone who is in dire shape alive for several days until they find a surrogate to decide weather or not the patient wants to be kept alive. Keeping the patient alive for this search costs money, money the surrogate or patient could very well not have. This means the state or hospital would have to pay for this week of life support.

            Even with this rational in mind it is absolutely ludicrous that the doctors can decide for a patient, with no consent weather or not to resuscitate them. The idea of deciding if someone wants to be kept on life support being up to the doctor like this legislation suggests is insane to me. The patient should clearly state if they would like to be kept alive on life support before any accident that leads to this decision being made but if not, the decision should be left up to the family of the patient. Not the doctors. There has to be another way to pay for the life support that makes more ethical sense than just deciding to take a patient off of life support without contacting a surrogate to make the decision.

http://www.cbc-network.org/2013/02/forced-dnr-coming-to-texas/

Pumping Iron: Do Performance Enhancing Substances Have A Place In Athletics?

In a recent news analysis piece of The New York Times, David Ewing Duncan comments on famed cyclist Lance Armstrong's tragic demise following his admission to using forbidden performance enhancers and summarizes the growing tension between anti-doping agencies and athletes that will undoubtedly escalate during this century due to the improvement of sports medicine and biotechnology in general. Perhaps the most interesting part of the article was Duncan's analysis of the rules prohibiting sports performance enhancers. Citing individuals who feel that the current set of such rules involve arbitrary distinctions with little scientific grounding, he mentions Dr. Andy Miah's proposal for enhanced sports contests designed for individuals who wish to compete without being bound by the various sporting regulations. Aside from being arguably less arbitrary in its rules, such a system would also allow athletes to use performance enhancing drugs safely and compete in an environment where everyone would have the opportunity to take advantage of these substances, thus allowing for a more even playing field.

This part in particular caught my attention because I have found all of the ethical arguments against performance enhancing drugs (some of which are alluded to in the article) to be rather weak. Claims centered around “protecting the spirit of athletics” or “maintaining the purity of sports” carry with them no sophisticated argumentation and are thus not ethically interesting. The fact of the matter is that, as far as I can see, there is no principled objection to the use of performance enhancing substances under any major ethical theory. Consequentialism clearly allows for it just in case the consequences of using such substances maximize the good, whereas deontological theories such as Kant's seem to permit it given that the decisions to use these substances lie entirely within an individual's autonomy. Even virtue theories and natural law perspectives appear to allow for such drugs since they do not even harm the body but are instead intended to enhance and strengthen its functions. Given the lack of a good argument against their use, why do sports organizations (and the law as well) prohibit their use?

I strongly suspect that the answer, in addition to consisting of the types of arguments mentioned above, also relates to the fact that many of these prohibitions are based off of our presnet ignorance of the long-term effects of these drugs. As Duncan points out, although we may be able to categorize some substances as less harmful than others in the short-term, we simply have not done enough research to know their long-term consequences.

It seems to me, however, that this is not a good justification for outright banning the substances from non-medical use, let alone athletic competitions. As it stands, we do not know the long-term health effects of certain diets like the Atkins diet (which has been criticized and even condemned as dangerous by some researchers while praised by others), but that fact, contra Mayor Bloomberg, certainly is not a reason to prevent people from choosing to eat in accordance with them. This, of course, is not perfectly analogous to the use of performance-enhancing substances, but it at least should give a critic of their legality and use in sports some pause before immediately rejecting them. Even more, however, is the fact that given the rapidly growing advancement in medicine that will transpire within this century, we may well be able to determine the substances that cause long-term harm and ban those, while leaving the harmless ones more readily available. If this could be done, then it seems that there would be no reason to ban them, either in the law or in sporting events.

Don't waste years in Medical school! Just stop at Walmart, and pick up your Medical degree today!

            Technology health checkpoints from a company called SoloHealth are now present in stores like Walmart. For free, customers can screen their vision, weight, BMI and blood pressure in just a few minutesA. They also enter information about their diets and health, and the machines offer health care advice. The company, who is trying to get the FDA to make certain medications available over the counter, hopes that the machines will eventually do more. They will allow customers to self-diagnose and medicate for conditions such as high cholesterol, and they will assess whether or not customers are at risk for diabetes, for example. The technological revolution of health care is often applauded as a way to make health care more affordable. Some argue that the machines will benefit people by allowing them to track their health themselves, even if they do not visit a doctor.

            However, there are many ethical and medical issues involved in this emerging self -diagnosis and treatment system. First, there is the issue of privacy. Customers are voluntarily offering private information about their health and lifestyle, so their privacy is not protected under law. It is impossible to know whether the companies will store this information or what they might do with it. Advertisements that appear on the machine are already targeted to the customers’ answers about their health, and the machines send advertisements and follow up emails to customers who enter their email addresses. It is clear that the purpose of these machines could easily be switched from providing good health care advice to using customers’ information to target advertising and keep customers shopping at Walmart. This could potentially result in inadequate or framed healthcare advice, which could be very dangerous to customers.

            I think that the major issue with this development, though, is the possibility that customers will start to value check-ups with actual doctors even less. These machines, whether it is the company’s intent or not, send the message to customers that self-diagnosis is generally sufficient, possibly equivalent to seeing a doctor. However, this is a dangerous message to send. Certain symptoms may seem minor to a non-trained individual, and when that individual inputs these symptoms, the machine could validate their opinion and direct them to a simple over the counter medicine. However, a physician might see that simple back pain or a sore throat is masking a more serious disease. If caught early, perhaps at a yearly check-up, better treatment is probably available. However, if the individual thinks that his own opinion is sufficient and he thus feels no need to see a doctor, then there could easily be sufficient time for a serious disease to worsen, limiting viable treatments. Annual check-ups with doctors are important because doctors are trained to see what the average individual cannot and to ask questions that other people might not realize are relevant. If people learn to think that every average Joe can play the role of doctor with the help of these self-diagnosis machines, more and more people will skip annual checkups, saving money because they think that consulting these machines and websites like webmd constitutes sufficient health care.  Thus, more people’s more serious conditions will go undiagnosed for longer, a very serious problem.

            Overall, machines could easily offer health care advice of bad quality, either because they are inappropriately geared towards advertising or because the connections that a doctor might see go unnoticed. Also, they might give people a false sense of security that they do not need to see doctors. Thus, we must proceed with caution when making technologically aided self-diagnosis a larger part of the health care system.

http://www.bioethics.net/2013/02/walmart-health-screening-stations-touted-as-part-of-self-service-revolution/

The Easy Way Out?: Treating Type 2 Diabetes with Bariatric Surgery

Bariatric surgery.  Also known as weight loss surgery.  A lot of people, myself included, sense something ethically wrong with this.  Most objections have to do with the fact that obesity is not a disease, and furthermore it is (for the most part) self-inflicted.  Thus it seems that bariatric surgery is almost a form of cheating: while the rest of the world struggles with exercise and diet, you can just go to sleep for a couple hours and wake up with the ideal beach body!  But what about if someone’s life is at stake?  For patients who acquire Type 2 diabetes, obesity becomes a disease.  In cases like this, when aesthetics are not the motive, is bariatric surgery ethically permissible?

            Type 2 diabetes, which is linked to obesity, can cause life-threatening complications including high blood pressure, heart disease, strokes and kidney failure.  Currently in the United States, there are more than 20 million diabetes patients.  The most common advice these individuals receive is to focus on improving diet and exercise.  Often, these recommendations bring about negligible improvement.

However, last spring, Denis Grady of the New York Times reported in the article “Surgery for Diabetes May Be Better Than Standard Treatment” that medical studies have shown that surgery may be more effective than standard treatments in combating Type 2 diabetes.  Patients who underwent this new surgery, “which stapled the stomach and rerouted the small intestine” (Grady), lost as many as 100 pounds and subsequently needed fewer medications.  Furthermore, many experienced drops in cholesterol and blood sugar, and some enjoyed total remission.

Though this form of bariatric surgery has been performed before in the United States, those individuals who opted for it had to pay for the operation personally if their insurance failed to cover it.  This is a serious investment as the surgery costs between $11,000 and $26,000 and has significant risks “[. . . ] including infection, nutritional deficiencies, bone loss and surgical problems [. . .]” (Grady).  Nevertheless, in the near future, bariatric surgery could potentially be publicly funded and be offered on a wider basis to any individual with Type 2 diabetes.      

              Though bariatric surgery is not technically a form of plastic surgery, the relevant ethical and legal considerations are similar.  Accordingly, while many may object to bariatric surgery on moral grounds, if a patient is able to pay for it out of his or her own pocket (and not that of the public healthcare system) bariatric surgery will probably remain a legally permissible option.  However, the question remains of whether or not patients with Type 2 diabetes should be eligible to receive this surgery even if they (or their private insurance companies) cannot pay for it independently.

            Considering the costs and risks involved, bariatric surgery should certainly not be the initial treatment received by Type 2 diabetes patients.  In fact, even relying on bariatric surgery as a last resort is risky because this could deter patients from combatting diabetes through natural weight loss methods.  All individuals with Type 2 diabetes should first be advised to follow the traditional regimen of exercise and healthy eating habits. 

Nevertheless, bariatric surgery should not be ruled out entirely because it does have the potential to save lives.  Thus it seems that if a patient is at severe risk and proves to have vigorously attempted to lose weight over a sustained period of time, but still is unable to make headway, that individual should be eligible to apply for publicly funded bariatric surgery.  In all cases, this option must be thoroughly regulated, and qualification must be decided on a case-by-case basis.  While surgery may still be the “easy route” compared to the strict lifestyle choices that most have to make to combat obesity and Type 2 diabetes, it is better to give the occasional break than condemn someone to imminent death.  Therefore, when the circumstances are right (which should be a rare occurrence), I believe bariatric surgery is both legally and ethically acceptable.

http://www.ncbi.nlm.nih.gov/pubmed/21479827

http://www.nytimes.com/2012/03/27/science/to-combat-diabetes-weight-loss-surgery-works-better-than-medicine-studies-find.html?pagewanted=all