BIOMEDICAL ETHICS What finishes will or ought to the new innovation serve? What qualities ought to guide society\'s conformities? By what guidelines ought to the appraisal organizations evaluate? What do we mean by the advancement of mankind? What is a decent individual? What is a decent life? What is a decent group?Slide 2
1. Control of Death 2. Control of Life 3. Control of Human (hereditary) Potential 4. Control of Human Achievement Kass, Leon. (1971). The New Biology: What Price Relieving Man\'s Estate? Science , 174(4011):779-788 "THE NEW BIOLOGY"Slide 3
Kass, Leon. (1971). The New Biology: What Price Relieving Man\'s Estate? Science , 174(4011):779-88 "THE NEW BIOLOGY" "… we might be quickly procuring the ability to adjust and control the limits and exercises of men by direct mediation and control of their bodies and psyches." [p. 779]Slide 4
Kass, Leon. (1971). The New Biology: What Price Relieving Man\'s Estate? Science , 174(4011):779-88 "THE NEW BIOLOGY" "Biomedical innovation may roll out it conceivable to improvement the inborn limit for decision itself… people can surprisingly reproduce themselves."" [p. 780]Slide 5
CONTROL OF DEATH Heroic Medicine/Euthanasia Infant Mortality Organ Transplants/Stem Cells Infectious Disease Degeneration/AgingSlide 6
CONTROL OF DEATH What is Death ? "The nonattendance of life" "The lasting end of all life capacities in a life form or part of a creature" "End of every single imperative capacity without the ability of revival" "The irreversible loss of all cerebrum work"Slide 7
HEROIC MEDICINE Karen Ann Quinlan 1975; blended liquor & sedatives; go out; suctioned upchuck "determined vegetative state" Parents battled to evacuate life bolster After expelling support, she experienced an additional 10 yearsSlide 8
HEROIC MEDICINE Terry Schindler-Schiavo 1990; K lack; trance like state Woke a couple of weeks late in a "bolted state" Receives sustenance and water through gastic nourishing tube In 1998 Terri\'s significant other requested that have the sustenance tube expelled; guardians battled; as yet pendingSlide 9
Moderate Protestants Liberal Protestants Fundamentalists Catholics Moderate Strong Minimal EUTHANASIA [NORC, 1977-94; General Social Surveys Combined] Percent Affirmative Responses (%)Slide 10
None Moderate Strong Minimal EUTHANASIA [NORC, 1977-94; General Social Surveys Combined] Percent Affirmative Responses (%) 0-11 yrs Some College 4+ years College HS graduateSlide 11
INFANT MORTALITY US Infant Mortality by "Race" [National Center for Health Statistics, 2001]Slide 12
ORGAN TRANSPLANTS Which organs? Kidney Heart Liver Lung Pancreas Intestine Cornea Skin Bone MarrowSlide 13
ORGAN TRANSPLANTS Survival Rates - 98% kidney 95% liver 85% heart 79% pancreas 70% small digestive tract 70% multi-organ 65% lungs 65% heart/lungsSlide 14
90,000 80,000 70,000 60,000 # of patients 50,000 40,000 30,000 20,000 10,000 \'92 \'93 \'94 \'95 \'97 \'98 \'99 \'01 \'91 \'96 \'00 Number of transplants Patients on hold up rundown at end of year ORGAN TRANSPLANTS [OPTN, December 31, 2002]Slide 15
< 0.30 - <0.60 0.60 - <0.70 0.70 - <0.80 0.80 - <0.90 0.90 - <1.0 ≥ 1.0 ORGAN TRANSPLANTS UK Organ Donors [as of Dec 31, 2002] Registrants (millions) [NHS, December 31, 2002]Slide 16
ORGAN TRANSPLANTSSlide 17
ORGAN TRANSPLANTS Who Gets the Transplants ?? Youthful, white, young men Wealthy people Shortage of accessible organs = lucrative bootleg market exchange Cycle of transplant get to = rich to poor; dark to chestnut to white; female to maleSlide 18
ORGAN TRANSPLANTS Suggested Solutions Education projects to evoke more contributors Futures showcase - money related motivating force benefactor\'s kinfolk Use organs from executed detainees Regulated transplant focuses Non-human sources Mandatory giftSlide 19
In Vitro Fertilized Egg Blastocyst Stage Inner Stem Cell Mass Undifferentiated Cells Specialized Cells platelets neural cells muscle cells FETAL TISSUES Undifferentiated cells that can be effortlessly controlled Cannot turn into a hatchlingSlide 20
Limb Amputations Neurological Disorders Spinal Cord Injuries Heart Disease Burns Diabetes FETAL TISSUES TreatableDisorders Understand human development and advancement Pharmacology Restore any cell sortSlide 21
FETAL TISSUES Spinal rope wounds Parkinson\'s Alzheimer\'sSlide 22
INFECTIOUS DISEASE Infectious Disease Rates, US * Cases per 100,000 [CDC Control & Prevention, (2001). Synopsis of outstanding ailments, Morbidity and Mortality Weekly , 50(53)]Slide 23
INFECTIOUS DISEASE Infectious Disease Rates same patterns to not show up in all portions of US society same patterns to not seem overall expanded destructiveness of once "vanquished" ailments developing pathogensSlide 24
DEGENERATION [CDC, December 31, 2003] * US future = 78.16 years ** UK future = 77.14 yearsSlide 25
CONTROL OF DEATH Schiavo Kevorkian UK Standards Right to Die Ronald Regan Christopher Reeves Michael J. Fox Stem Cell Research Socio-financial partition Changing demographic National Health Care ? Medicinal services Benefits 2/3 $$ a month ago Rationed care Utah arrange Cost of Medical Care Eldercare Changing demographic From children to guardians IsolationSlide 26
CONTROL OF LIFE "Unnaturally conceived children" In vitro preparation 1978; Edwards & Steptoe Baby Louise Brown Common practice today particularly for more established ladies Not endorsed by the Catholic churchSlide 27
Sperm test Hormone infused Fertilization of egg Pregnant mother Insertion of fetus into uterus Suction gadget Nutrient arrangement Blastocyst Recovered eggs CONTROL OF LIFESlide 28
CONTROL OF LIFE What to do with push off cells? What are the legitimate privileges of incipient organisms? Whenever utilized, what are the privileges of the surrogate mother? Who are the surrogates? Who\'s in charge of a deficient child?Slide 29
HUMAN POTENTIAL 6% of conferences with specialists are identified with hereditary issue 26% of every institutional bed are involved by patients with hereditary issue 8.5% of all newborn child passings are the consequence of a solitary quality deformity Over 600 single quality imperfections are known, another 800 suspected by and large, we as a whole convey 6-8 blemished qualitiesSlide 30
HUMAN POTENTIAL Negative Eugenics - recognize & dispense with undesirable hereditary attributes Ultrasound Chorionic villi testing Amniocentesis Genetic directing SterilizationSlide 31
handheld transducer HUMAN POTENTIAL Ultrasound utilizes sound waves identifies noticeable deformitiesSlide 32
HUMAN POTENTIAL Amniocentesis Combined w/ultrasound fetal waste itemsSlide 33
HUMAN POTENTIAL Chorionic Villi Testing Microscopic projections coating the furthest layer of the embryonic sac same hereditary material as baby inspected at 10-12 weeks incubation quick turnaround timeSlide 34
HUMAN POTENTIAL Genetic CounselingSlide 35
HUMAN POTENTIAL Sterilization Carrie Buck caseSlide 36
HUMAN POTENTIAL Positive EugenicsSlide 37
HUMAN POTENTIAL CryobanksSlide 38
HUMAN ACHIEVEMENT Neurological, mental and physiological control Mood adjusting & improving solutions Cosmetic endrochronologySlide 39
HUMAN ACHIEVEMENT Valium diazepam addictive potential high - 2 wks birth deserts - \'floppy tyke\' disorder \'for help of psychic pressure and its physical indications\' females dwarf clients 2.5 to 1Slide 40
HUMAN ACHIEVEMENT Valium most generally recommended tranquilize worldwide in the 60s & 70s advertised to our longing for a \'decent life\' endorsed for nervousness, sorrow, sleep deprivation, and uneasiness brought about misery, tension, and a sleeping disorderSlide 41
Growth Hormone HUMAN ACHIEVEMENT Growth Hormone given to ordinary yet little children include 6" stature, half bulk recombinant DNA innovationSlide 42
Hypothalamus Antidiurectic Hormone Adrenal Cortex Adrenocortotropic Hormone Kidney Tubules Oxytocin & Prolactin Thyroid Stimulating Hormone Pituitary Thyroid Oxytocin Gonadotropic Hormone Mammary Glands Growth Hormone Gonadotropic Hormone Testis Uterine Muscles Ovary Bone HUMAN ACHIEVEMENTSlide 43
Rational or Rationed Medicine ? Derek Roberts Peter Singer BIOMEDICAL ETHICS Control of barrenness, increment in future, decrease in newborn child mortality , lessened irresistible malady = reduced points of confinement on populace development Should everybody have entry to mind, paying little heed to affliction ?Slide 44
Rational or Rationed Medicine ? Derek Roberts Peter Singer BIOMEDICAL ETHICS $4,700 per individual every year paid for social insurance increments at 6X the rate of expansion every year High deductibles for families - $2,000 Racial gap in get to, paying little respect to paySlide 45
BIOMEDICAL ETHICS Rational or Rationed Medicine ? Derek Roberts 0 = costs nothing, gives back alot 3 = costs a bit, gives back somewhere in the range of 7 = society maintains them past what they pay back Peter Singer 10 = costs from the begin, impractical to pay backSlide 46
BIOMEDICAL ETHICS What closures will or ought to the new innovation serve? What qualities ought to guide society\'s modification? By what guidelines ought to the evaluation organizations survey? What do we mean by the advancement of mankind? What is a decent individual? What is a decent life? What is a decent group?
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