Tuesday, December 16, 2014

Why Do Doctors Fail?

One of our upcoming authors in Bioethics next semester, Atul Gawande (Being Mortal), has joined distinguished company - Bertrand Russell, Arnold Toynbee, Robert Oppenheimer, and J.K. Galbreath et al - with his Reith Lectures, commencing with "Why Do Doctors Fail?"

Surgeon and writer Atul Gawande explores the nature of fallibility and suggests that preventing avoidable mistakes is a key challenge for the future of medicine.
Through the story of a life-threatening condition which affected his own baby son, Dr. Gawande suggests that the medical profession needs to understand how best to deploy the enormous arsenal of knowledge which it has acquired. And his challenge for global health is to address the inequalities in access to resources and expertise both within and between countries.
This first of four lectures was recorded before an audience at the John F Kennedy Presidential Library and Museum in Dr. Gawande's home town of Boston in Massachusetts. The other lectures are recorded in London, Edinburgh and Delhi.
Previous Reith Lectures

NY Review of Books (@nybooks)
Marcia Angell on getting old, and on choosing when to die j.mp/1wbDL6v


Our bodies age. As members of the kingdom of animals, we inherit a biology that grows less efficient with time. Glitches and injuries accumulate. Our youthful form is lost, and our aged one is gained.
By dint of fear of change, the innate sexual attractiveness of younger bodies, and massive exploitation of both by marketing forces, we feel embarrassed and deprived as our bodies slowly deteriorate.
Not all cultures view aging so negatively. So the bias could be overcome. But how?
  1. Don’t take aging personally. After all, aging happens to everyone, from the beginning of life until its end. And like they say, Growing old beats the alternative! Every person who has ever lived beyond early adulthood has grappled with the changes the years impose. Granted, some people age more slowly than others, but every one of us looks and feels older as time passes. You are not alone.
  2. See aging as Natural. We live in an era when ‘organic,’ ‘all-natural,’ ‘non-GMO,’ ‘cage-free,’ and other eco-marketing catchphrases are used to sell products. Moderns want the growth and harvesting of foodstuffs to proceed naturally. Well, aging is no less aligned with Nature than vegetables cultivated without pesticides; why not embrace growing older the way we embrace organic foods?
  3. Appreciate the gifts of aging. As we grow older, we grow wiser. This isn’t folk mythology; it’s fact. We learn from experience. We find more acceptance in our hearts. We assess our strengths and weakness with more humility and self-compassion. We begin to view circumstances in shades of gray rather than black-and-white. Youthful hunger wanes until we find ourselves valuing what matters over the long run above what feels pleasant in the short run. We care less about personal goals and more about collective ones. To my mind, at least, the gain of gentleness, nuance, and altruism more than compensate for the lessening of passion and militance.
  4. Embrace the big picture. If you listed the names of all 108 billion people who have ever lived, at the rate of one per second, it would take 3,400 years. And the entire human saga has unfolded over just the last 0.005% of the time since life began on this planet. Does it make sense to feel affronted by a body’s aging when so many people (and countless other lifeforms) have endured the same fate, and when the span of even the longest human life barely measures as a single tick on the cosmic clock? Each of us is a unique product of history, but we delude ourselves if we believe our own lives more important than those of all the others. If we identify with Life as it has grown on this planet for billions of years, rather than our personal speck of biology, we gain freedom from the constrictions of daily concerns. We feel opened to a larger world, a larger sense of Self, and the great, beautiful mystery that is Living.
  5. Nurture a sense of humor. It helps to take aging less seriously. Early in 2014 I underwent major surgery. Postoperatively, I was horrified to see how the abdominal muscles I’d been strengthening for years ended up looking scarred and distorted. It helped lessen the sense of grief when I joked about losing my ‘last bastion of sexiness.’ The use of humor has a long history of helping the aged feel less burdened by wrinkles, sags, dribbles, creaks, and farts. Join the fun!
http://blogs.psychcentral.com/childhood-adversity/2014/12/4-ways-to-embrace-aging/
==
Being Mortal, which was published in October, is ostensibly about the struggle to cope with the constraints imposed by flesh-and-bone biology—and the failure of medical science to acknowledge that any ability to push back is finite. Gawande's ultimate message, that death in America is not often enough discussed, and that patients suffer at the hands of well-meaning doctors because of it, has been generally celebrated, though not for breaking particularly new ground. His is the basic message for which the late surgeon Sherwin Nuland's How We Diewon a National Book Award 20 years ago; and it's the message of another book released last week, The Conversation, by another Harvard physician, Angelo Volandes. It's a message that has grown extremely loud inside of the health-professional echo chamber, but is somehow still only faintly reverberating into broader culture. 
"I think too many people don't know what's going on behind those closed doors in hospitals," Volandes told me. "But if they did, they'd be outraged. So many people are getting—not costly care—I'm talking about unwanted care..." (continues) 


Wednesday, November 19, 2014

"How Medical Care is Being Corrupted"

WHEN we are patients, we want our doctors to make recommendations that are in our best interests as individuals. As physicians, we strive to do the same for our patients.
 
But financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital networks and regulatory groups have put in place both rewards and punishments that can powerfully influence your doctor’s decisions... nyt
 
(continues)

Wednesday, October 22, 2014

"Worried About MCAT 2015?"

Spotted this a.m. in the Science Building on our campus:


Thanks to Prof. Amy Jetton for creating the slide and putting it in rotation!

Wednesday, October 15, 2014

Bioethics

Returning to MTSU January 20, 2015-


PHIL 3345
Bioethics
Tuesdays & Thursdays 4:20-5:45 pm
BAS S113
(CRN #17011)


Exploring ethical issues arising from the practice of medical therapeutics (conventional and “alternative”), new biotechnologies, and reflection on life’s deepest meanings and prospects. This semester, mirroring the new MCAT, our readings will also “stress the psychological and social dimensions of medicine.”


TEXTS:
  • Bioethics: The Basics - ”...the word ‘bioethics’ just means the ethics of life…”


  • The Case Against Perfection - “When science moves faster than moral understanding, as it does today, men and women struggle to articulate their unease…”


  • On Immunity - “If we imagine the action of a vaccine not just in terms of how it affects a single body, but also in terms of how it affects the collective body of a community, it is fair to think of vaccination as a kind of banking of immunity.”


  • Being Mortal -  “We’ve been wrong about what our job is in medicine. We think it is to ensure health and survival. But really it is to enable well-being. And well-being is about the reasons one wishes to be alive.”


For more info, email Phil.Oliver@mtsu.edu







Saturday, September 6, 2014

Bioethics and the MCAT

It's coming, and with it new emphasis on bioethical issues. We won't be teaching to the test, in our course; but the test will now reflect greater attention to critical thinking and the "heart and soul" issues that are our course's focus. 

MCAT 2015 FAQs... What's on the MCAT 2015?... Psychological, social, and biological foundations of behavior section


Pre-Med's New Priorities: Heart and Soul...
"...what’s really exciting is not that taking this class will get these kids into medical school, but that it will help them become better physicians... The goal is to improve the medical admissions process to find the people who you and I would want as our doctors. Being a good doctor isn’t just about understanding science, it’s about understanding people.
The adoption of the new test, which will be first administered in 2015, is part of a decade-long effort by medical educators to restore a bit of good old-fashioned healing and bedside patient skills into a profession that has come to be dominated by technology and laboratory testing. More medical schools are requiring students to take classes on interviewing and communication techniques. To help create a more holistic admissions process, one that goes beyond scientific knowledge, admissions committees are presenting candidates with ethical dilemmas to see if their people skills match their A+ in organic chemistry.
...the Association of American Medical Colleges began three years ago to redesign the MCAT, surveying thousands of medical school faculty members and students to come up with a test tailored to the needs and desires of the 21st century. In addition to more emphasis on humanistic skills, the new test had to take into account important new values in medicine like diversity, with greater focus on health care for the underserved, Dr. McGaghie said.
As a result, there will be questions about gender and cultural influences on expression, poverty and social mobility, as well as how people process emotion and stress. Such subjects are “the building blocks medical students need in order to learn about the ways in which cognitive and perceptual processes influence their understanding of health and illness,” explains the preview guide to the new MCAT.
“I used to think of medicine as very methodical: you get the symptoms, find the diagnoses and treat,” she said. “Now it has made me think beyond pathology and biochemistry to the person. It’s made me think, ‘How will I communicate with them?’ ”
Professor Hale at Oklahoma said that, with a far larger component of pre-meds in his class, he had fielded new types of questions. “When pre-meds approach an ethics class, at first it’s: just tell me what to do to be ethical,” he said. “They’ll come saying they’ve been put in the class by an adviser, but then discover it’s relevant.”
...“I know what society needs and what patients want. They want a doctor who is technically competent but who also understands who they are. How to get there is more complicated.” 
POP QUIZ

The New MCAT

In February, the Association of American Medical Colleges approved an overhaul of the MCAT, due in 2015. New sections will stress the psychological and social dimensions of medicine (the samples below have been edited for length). 

QUESTIONS 1-4 Psychological, Social and Biological Foundations of Behavior

Psychologists have identified two forms of bias: explicit and implicit. Explicit bias is a conscious preference, whereas implicit bias is unconscious. Research on racial disparities in treatments for heart attacks has found that blacks are significantly less likely than whites to receive thrombolytic therapy (the administration of drugs to break up or dissolve blood clots). A study investigated the relationship between physicians’ implicit and explicit biases. Participants received a vignette describing a 50-year-old male with heart attack symptoms. Half the vignettes included a photo of a black patient; the other half a photo of a white patient. After participants indicated whether they would refer the patient for thrombolytic therapy, their preferences for blacks and whites were measured using a five-point Likert scale. Next, participants completed an Implicit Association Task (I.A.T.), which measured their response time to valenced words (words with good or bad connotations) that were presented with images of black and white individuals. No effect was found for levels of explicit bias and the likelihood of providing thrombolytic therapy. Figure 1 summarizes the findings related to implicit bias.
Diagram

QUESTIONS

1Which concept is the focus of this study?

  1. Fundamental attribution error
  2. Elaboration likelihood model
  3. Modern prejudice
  4. Self-serving bias
Move your mouse over this block for the correct answer.C

2Which of the following explanations describes why the amygdala would most likely be activated by the use of the I.A.T. in this study? The amygdala is important for:

  1. learning
  2. fear
  3. anxiety
  4. value judgments
Move your mouse over this block for the correct answer.B

3How would a social identity theorist most likely explain the results summarized in Figure 1?

  1. The physician is ethnocentric and places high value on belonging to his racial in-group.
  2. The physician perceives blacks as competing with whites for scarce societal resources.
  3. The physician is a product of prejudiced parents and peers.
  4. The physician is surrounded by inaccurate stereotypes.
Move your mouse over this block for the correct answer.A

4Which conclusion is supported by the findings?

  1. Participants high in implicit bias prescribed thrombolytic therapy for black patients more often than for white patients.
  2. Participants prescribed thrombolytic therapy less than 50 percent of the time for all patients, regardless of their implicit bias levels.
  3. Participants high in implicit bias prescribed thrombolytic therapy for black patients 77 percent of the time.
  4. Participants high in implicit bias prescribed thrombolytic therapy for white patients more often than for black patients.
Move your mouse over this block for the correct answer.D

QUESTIONS 5-9 Critical Analysis and Reasoning Skills

A covenant of confidentiality characterizes physician-patient relationships. But suppose that during a routine medical examination, a prison physician notices that Prisoner A has drugs and paraphernalia. Should the physician report the crime or should confidentiality prevail?
Professional communications between physicians and patients are statutorily protected as confidential. Health professionals have an interest in maintaining confidentiality so patients feel comfortable revealing personal but necessary information. Prisoners do not possess full constitutional rights to privacy but generally retain them in the physician-patient relationship. In fact, respect for confidentiality is particularly important in a prison hospital setting, where patients feel distrust because physicians are often employed by the incarcerating institution. Even then, physicians’ first responsibility is to their patients. Circumstances in which to give privileged information to authorities remains the physician’s decision.
The right to privacy supersedes a duty to report the drugs and paraphernalia as there is no imminent threat to others. In contrast, a weapon harbored by a prisoner represents an imminent threat to others. Thus, upon discovering a sequestered weapon during a routine examination, the physician has a “duty to warn.”
The possibility of discovering contraband reinforces the need for informed consent at several stages. First, patients should be evaluated and treated only after they provide informed consent, unless they are incompetent. Before an X-ray is taken, they should be informed that it can demonstrate metal and other foreign bodies, and their agreement to the procedure obtained. Second, if a weapon is discovered, the patient should be given the opportunity to surrender it to authorities. And if Prisoner A is harboring drugs and a needle, it is the physician’s responsibility to educate about the potential harm of drug use.
— Adapted from “Cases in Bioethics: Selections From the Hastings Center Report,” 1989

QUESTIONS

5Assume that a prison did not have a policy of obtaining informed consent before a diagnostic procedure, and almost all of the inmates refused to be X-rayed. The author’s comments suggest this situation could be evidence that prisoners:

  1. believe that they have a constitutional right to privacy.
  2. are less concerned about their health than are nonprisoners.
  3. distrust physicians employed by the prison.
  4. feel a need to carry weapons for protection.
Move your mouse over this block for the correct answer.C

6Suppose that a prisoner under sedation for a medical procedure inadvertently reveals that a weapon is hidden in his cell. The author of the passage would be most likely to advise the physician to report the incident:

  1. only if the prisoner threatened to use the weapon.
  2. only if the prisoner consented to the report.
  3. only if the prisoner subsequently denied that the weapon existed.
  4. regardless of the patient’s assertions.
Move your mouse over this block for the correct answer.D

7With respect to prisoners, “necessary information” (paragraph 2) probably refers most specifically to a patient’s:

  1. past criminal activities.
  2. use of illegal drugs.
  3. intent to harm others.
  4. psychiatric history.
Move your mouse over this block for the correct answer.B

8Which of the following conclusions about physician confidentiality can be inferred from the passage?

  1. It is more likely to be assumed in a private setting than in a prison.
  2. It is especially important when patients are incompetent to give informed consent.
  3. It is threatened by the use of invasive diagnostic tools such as X-rays.
  4. It is an aspect of a constitutional right that is lost by prisoners.
Move your mouse over this block for the correct answer.A

9Which of the following objections, if valid, most weakens the argument made for the special importance of the physician-patient covenant within prisons?

  1. Prisoners understand that X-rays will detect hidden weapons.
  2. Prisoners assume that physicians are independent of the institution.
  3. Prison officials often question physicians about prisoners.
  4. Prisoners often misunderstand their constitutional rights.
Move your mouse over this block for the correct answer.

Tuesday, April 29, 2014

The end

April 29

Our last class! No quiz, but a couple of DQs for your continued reflection.

1. “She’s still alive, my invented friend, just as I conceived her, still uncrushed by the collective need for happier endings.” What do you make of the way Generosity ends (it doesn't, really, does it), and how would you plot the sequel? Will things work out for Thassa, for Stone, for Kurton, for the others, for us

2. Really the same question, "the really vital question for us all is, What is this world going to be? What is life eventually to make of itself?" (Pragmatism)

May life be good to you all. I've enjoyed our semester together. Keep in touch. Be well!

Thursday, April 24, 2014

Dustin Wells presentation will be on transhumanism.

No Daily Quiz

But I invite you to consider & comment on my concluding thoughts on Blackford's Humanity Enhanced & on Part 3 of Generosity: "What doesn't kill you..."

Also of possible interest: "Liver Means Heart and Heart Means Joy"

Group 1- HE,Chapter 8

(FQ) What is Farrelly's "reasonable genetic intervention model" meant to control?
Answer: Governmental interventions in the reproductive freedom of parents (pg. 180)

(DQ) What would happen if the government gained too much control over parents' choices in potentially modifying their children?

Link: http://www.organicconsumers.org/ge/fudgedgetests.cfm

PGD Presentation

My presentation on pre-implantation diagnosis (PGD) will focus more on the science behind the genetic selection of embryos. Although we have discussed "designer babies" and mentioned PGD  at great length, the actual process has usually only been skimmed. I know that sometimes my understanding can be enhanced through pictures and further explanation, so before we leave this class I thought it would be beneficial for us all to have a very well-rounded knowledge of PGD in case we are faced with the possibility of genetic enhancement for our future children. This includes how much the procedure costs and some negative medical consequences that are possible.

Here is a link describing what PGD is and some questions people should ask before they follow through with the procedure.
http://www.givf.com/geneticservices/whatispgd.shtml

Here is a link about "digital baby" screening:

Tuesday, April 22, 2014

Group 2

     Alyssa started with a presentation on memory manipulation.  This entails adding and deleting memories from a person.  What are the issues that arise when talking about this?  Could a person suffering from PTSD cure themselves by deleting a traumatic memory? I feel this could have a few good uses, but overall I believe that this idea would lead to a dangerous erasure of the line between reality and fantasy...true and false. If a memory is added to a person, they now believe this event happened to them.  Or if a traumatic event happens to a person, if the memory of it was removed how can they learn from the event or learn to avoid situations like it in the future?  What if they need to recall the memory for some reason -- ie. they are called to court to testify against a dangerous criminal that could be removed from the public if you can recall what they did (I know this idea is a little iffy, but just a thought). Here is a link I found on the subject - Memory Manipulation.
     Cameron was next, and he discussed RFID chips.  They are used for storing data and tracking whatever the chip is implanted in.  Currently, one of their major uses is in tracking animals.  One of the major ethical concerns is the use of RFID chips in humans.  Can be used to keep up with a patients' medical record to call up medical history if patients are unconscious.  Can also be used as a method for payment so you don't have to carry a credit card...just scan your hand.  Are we de-humanizing ourselves by doing this?  There are also issues with people taking advantage and possibly "hacking" your information and taking advantage of this.  Many people had concerns about these issues.  "People could scan it anytime." "People could track me." "They could cut the RFID chip out of you." "Could police abuse this system?" These are just a few of the concerns brought up.  Here is a link to an article I found - RFID Privacy Concerns.
      Kat went into science fiction movies.  She started with Gattaca, a movie about eugenics.  It delves into a world where people are "classed" by whether people are genetically modified or not.  Would a hierarchy arise if people start to accept genetic modification?  Next, she discussed the Bicentennial Man.  A robot butler wants to become a human, so he comes up with a way to "humanize" himself, and eventually age and die.  What does it take to be human?  At what point (if ever) does Andrew become human?  We talked a bit about self-awareness and introspection.  Next we discussed the movie AI.  It follows an unconditionally loving robot boy who is made to love a woman whose son is suffering from an deadly disease.  Do robots (if self aware) have rights?  What would it take for David to be considered a "real boy?"  Do we have the right to destroy robots for our entertainment if they are self aware?  We also touched on the sex robots in the movie.  Then we talked about Repo Men.  A world where technological organs can be bought on credit to save your life, but if you don't pay then repo men will reposes your organ.  It follows one of these repo men who ends up with one of these organs but he did not consent to getting it.  It is a good thing to save a life with an organ the person will not be able to pay for?  Does this cast a bad light on the use of possibly life saving artificial organs?  We also touched on the Island.  Here is a link to an article about the ethics in sci fi - Ethics in Sci fi.
   
   

Daily Quiz

April 22

1. Why does Glannon say there'd not be complete equality even if enhancements were universally available?

2. How might "status quo bias" color some people's attitudes towards enhancement technologies?

3. What was Rawls' position on "the natural lottery" and whether a just society should accept its distributions unaltered? [And, DQ: What's yours?]

4. Does Blackford think the Original Position thought experiment supports Rawls' intuition about natural talents, family circumstances, and the distribution of social goods?

5. Does Kurton hope to live forever?

6. What's the difference between hyperthymia and hypomania?

7. What does Thassa's name mean, and imply?

DQ: Will competition for genomic enhancement be ethically problematic? Is competition problematic, in general? Or parental assistance and "gifts"? What would a "level playing field" look like, applied to the issue of genomic enhancement?

What do you think of the analogy to reparations for slavery? 156

Gattaca 161, Kurzweil 162, 167

Henry James, flow, interiority 55, 83, 88

Do you agree with Kurton? "When people can live longer and better, they will. Ethics is just going to have to catch up." 58

Would you watch Over the Limit? 62

What do you think of "nulliparity"? 65

Which of the debate resolutions would you defend? 66

$20 92; "infinite hunger for the unreal" 95; "plug & play chromosomes" 98; 78% "ready to enhance" 99

PGD, collective wisdom 101; "Walk on air against your better judgment" 103; "excessively happy" 106

"information travels at the speed of light, meaning spreads at the speed of dark" 111

"liver means heart, heart means joy" 114

"the kind of novel I loved to read, back before fact and fable merged... the kind that invents itself out of meaningless detail and thin air"  120; "All good science pauses" 123; "massively parallel computer, the entire human race" 127

1.134   2.138   3.139   4.143f.   5.59   6.68   7.78

Group 3

FQ: (T/F) One concern raised by the emergence of enhancement technologies is that new kinds of biologically based inequality will ensue, producing a radically unequal society in which some individuals suffer demeaning circumstances or other harsh outcomes.
A: True

DQ: What is your definition of "deserving?"

Group 3 Ch.6

We have spent some time going over the daily quiz questions and the discussion questions that followed. Dr. Oliver tried to convince those that havent started to read the Generosity to indulge on the journey of reading this great novel. He went over the first chapter of the novel. The class was dismissed a little early so that the presenters could have some time to themselves to figure out on what exactly they were presenting.

Ch.7 HE

FQ: Someone who wishes to nullify the underserved effects of luck is called _______?
(Brute luck theorist) p.139

DQ: Do you agree with Rawls' or Blackford's stance on the ''equality'' of genetic enhancement.

link: http://stanfordreview.org/article/arguing-and-against-genetic-engineering/

arguments for and against gen. eng. such as the limit to autonomy, discussion about eugenics, and growth of social inequalities.

RFID Chip Commercial

Monday, April 21, 2014

Earth Week Debate

"Is God possible in a dying environment?"



My debating opponent, like me, is on record denying the existence of a creator God.
I don’t believe in a God who created the universe, chose the Jews, gave us Torah, a Promised Land, and 613 mitzvot (commandments). I believe in a nondual reality evolving toward greater levels of complexity and higher levels of consciousness that ultimately gives rise to beings such as ourselves who can begin to understand this reality, and fashion meaning and purpose that promote justice and compassion for all beings. 
So, either one of us will have to defend a proposition he does not accept, or we'll spend too much time debating definitions ("God," "Atheism," "Possible") OR we'll have to change the subject. I vote for the latter. How about:
  • Is God-talk relevant or constructive in guiding our response to the climate crisis? 
  • Can religious piety make us better eco-citizens?
  • Are "higher levels of consciousness" and "meaning, purpose, justice and compassion for all" inevitable?
Or:
  • Is the environment (the planet) really dying, anytime soon? Or is it us?

Friday, April 18, 2014

Transcendence

Sorry we forget to look at this in class, Nikita. (But that was an interesting post-class discussion!)




Thursday, April 17, 2014

Group 1- HE, Chapter 6

We began class by discussing the DQ questions. According to Humanity Enhanced, the prospect of making genetic modification commonplace could lead to an alteration in the fabric of society, potentially culminating in a new system where it's the "enhanced vs the non-enhanced." Dr. O then went into detail and began a discussion on the novel Generosity. After a discussion on this novel, we were released slightly early to go read and prepare for the next class session.

Daily Quiz

The 3d exam has been canceled (I hate to throw a party and have nobody come), so we don't need the daily quiz for exam-building purposes any longer. But I still find it useful as a conversation starter, so I'll continue to ask FQs & DQs, & urge you all to do so as well. That'll still get you around the bases.
Starting next week, however, you can also circle the bases by posting questions, links, and comments about our presentations. They'll commence on Tuesday. We'll do three per class until we're done.
1.Why should we be wary of concerns about harm to society as a whole? OR, Why does RB discuss prostitution and homosexuality in this context?

2.What "special gifts" does Somerville think the elimination of Down syndrome, for example, might imperil? OR, What current values did Huxley fear losing, in Brave New World? OR, What's illiberal about Somerville's view, and Huxley's nightmare dystopia?

3.What do Henry James, James Joyce, Jane Austen, Saul Bellow (etc.) have to do with the Enhancement debate? OR, What did John Rawls say about society's interest in the "general level of genetic potentialities"?

4. Does RB acknowledge the possibility that some children might be harmed psychologically by knowledge of their parents' role in the selection of their gender or other traits? OR, What does Devlin say about the "social fabric" and toleration of moral divergence? Does RB agree? OR, What does RB say about "fearmongering"?

5. Does RB think there's a case for prohibiting enhancements that interfere with a person's natural range of facial expressions? Does he think we should avoid creating beings who are less responsive or sympathetic to others, even if they were benefited in other ways?

6. What sort of genetic "lottery" does RB consider? Does he endorse it?

7. {For Elijah] What's the relevance of tattooing, body piercing etc. in this discussion?

DQ: Should we value diversity for its own sake, or for instrumental goods it might make possible? 128f.

DQ: Reactions to Generosity, so far?

1.103-4   2.105-7   3.109,111   4.112-14, 116   5.118-19   6.123-4   7.126


Wednesday, April 16, 2014

Group 3

We spent the first part of our class time discussing the questions/answers from the daily quiz to review some of the highlights from the chapters. This led to the comparison between Blackford's view on genetic engineering versus McKibben's opinions from his book, Enough. It was pointed out how the offspring's autonomy can be affected by the genetic alterations chosen by the parents.

Tuesday, April 15, 2014

Group 1: HE, Chapters 4 and 5

After going over the Daily Quiz, we discussed McKibben and Blackford's conflicting views on genetic enhancement. An interesting notion was proposed that by engineering, an individual's ability to make a choice would not be taken away, but the likelihood of them accomplishing their true desires would be diminished. After discussing pertinent points from the book Enough, we looked over and discussed Dr. O's daily post briefly. To end class, we handed out scorecards and discussed the status of everyone's bases and final reports.

Daily Quiz

April 10/15

1. What's Annas's objection to parental enhancement? OR, What's Habermas's "twist" objection?

2. What's Glover's "priority," when we respect others' autonomy? OR, Name one of Glover's respect-for-autonomy conditions. OR, Can an embryo's autonomy be violated (on Glover's view)?

3. What's Strawson's "illusion"? OR, What are some of the standard philosophical positions on free will? OR, Does RB think genetically engineered people would be less free?

4. Does Glover think there are circumstances in which we might accept some loss of independence, even if that made us feel like puppets of our parents? OR, How must we be able to think of our origins if we consider ourselves free, according to Sandel? OR, Does RB consider genetics more fundamental than our environments?

5. To what did Feinberg say children have a right? OR, What are Bostrom's "blessings"? OR, Why does RB consider the open-future argument misguided?

6. What's "one good reason" for parents to consider refraining from using reproductive cloning or genetic engineering? Is it also (on RB's view) a good reason for state regulation?

7. Name one of Loftis' classes of arguments that are commonly deployed against genetic manipulation. OR, What were Hume's or Mill's positions on "natural" acts? OR, What does Peter Singer say is "natural" but not  advisable?

8. What's Bill McKibben's greatest concern about genetic engineering (i.e.., what does he think it would most threaten)? OR, What's RB's problem with "we"? OR, Does RB think future societies may differ dramatically from ours, and why is that relevant?

9. What's McKibben's point about runners and rock climbers? Does RB agree? OR, What's RB's view of McKibben's concerns about immortality?




1.50   2.52-3   3.54-6   4.60-1   5.63, 65   6.76   7.79-82   8.86, 89, 90, 93   9.97-8

DQ: What's your reaction to the Enough passages I am about to read in class?

(FQ) The views of this philosopher are recognized as best known and most elaborate in regards to the concept of autonomy.
Answer: Habermas (pg. 51)

(FQ) Name 2 of J. Robert Loftis' classes of arguments that are commonly deployed against genetic manipulation.
Answer: Safety, Justice, Trust, and Naturalness (pg. 79)

(FQ) T/F: McKibben is optimistic of genetic engineering, believing it will enable us to modify and improve the quality of humans' lives.
Answer: False (pg. 98)

(DQ) I'd like to see what about genetic manipulation is "against the natural order" to the class if anyone considers it that.

Link: http://www.nature.com/scitable/topicpage/embryo-screening-and-the-ethics-of-human-60561

FQ: We are shaped by an interaction between our _____ and _____ around us.
(genes, environment)

DQ: To what degree are we autonomous? I agree with C.A. Coady statement, which states that ''there is too much contingency and inevitable dependence on others'' for us to regard ourselves as sole authors of our own life.

link:http://www.sciencegroup.org.uk/ifgene/proscons.htm
pros and cons of genetic engineering 

  1. FQ)- Who wrote the book Causing Death and Saving Lives in which he suggests that respect for autonomy can ground an objection to killing other persons, over and above any utilitarian, or similar, consequences?
    Answer: Glover pg. 52

    (DQ)- I would like to hear if those in the class think that genetic engineering is a threat to liberal society.

    Link- This link discusses the value of autonomy in medical ethicshttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780686/
  2. HQ- What are some of the main arguments against genetic engineering?
    Safety/Justice
    DQ- Should society force people to become genetically modified and why? and if it is enforced how should it be enforced?
    Link:http://www.bioethics.gov/
    http://www.bioethics.net/2014/04/pharmaceutical-or-illegal-drug-the-bizarre-case-of-marijuana/
    http://missinglink.ucsf.edu/lm/ethics/content%20pages/fast_fact_auton_bene.htm
==

http://nyti.ms/1huRpiR

NYTimes: Providing the Balm of Truth

An angry family member wanted to give a dying woman aloe vera gel. No one had had time to tell her the truth.


http://nyti.ms/1jvzhol

NYTimes: A ‘Code Death’ for Dying Patients

In this new age of technological wizardry, doctors have been taught that they can, indeed must, do everything possible to stave off death, but few learn how to help their patients die.


http://nyti.ms/1jzdSLa

NYTimes: Idea of New Attention Disorder Spurs Research, and Debate

Powerful figures in mental health are claiming to have identified a new disorder, sluggish cognitive tempo, that could widely expand the ranks of young people treated for attention problems.


Bioethics Centre (@BioethicsCentre)
Veridical Engagement and Radical Enhancement, by @JohnDanaher [Philosophical Disquisitions] j.mp/1eB5UNc


Patricia Churchland (@patchurchland)
Geneographic costs a mere $200 and you can find out how much Neanderhal and Denisovan DNA you have. I was thrilledgenographic.nationalgeographic.com/?source=email_…