Epidemics (Make-Up for 3/29/16)

            If you ask the majority of society what they are thinking it is very unlikely that it is “germs” or “bacteria” or “epidemics.” It is also very unlikely that people think about how the things they do every day that could or do impact the rise of the next epidemic. Movies like World War Z, 28 Weeks Later, and Contagion bring scary factors of the reality how epidemics and pandemics come to rise but when movie goers leave the theater, the idea that something so dangerous is not impossible and will eventually happen escapes their minds. The closest thing to an epidemic that has occurred in the U.S. in the past few years is the outbreak of measles and mumps among unvaccinated children. Rather than focus on the “to vaccinate or not to vaccinate” topic I think the area of focus at this point is the rise of “superbugs” due to the over prescription of antibiotics and also the lack vaccinations or medication of some viruses. The most recent pandemic scare was the outbreak of Ebola in West Africa in 2013. Countries shut down their boarder and airlines prevented flights for certain countries and citizens of those countries but in reality people were still able to travel and bring the virus back with them. Multiple cases of Ebola have traveled to the US and thankfully multiple medical units and hospitals had procedures of how to handle the issue but we can’t always be so lucky. Just like it is stated in our reading “it's not a matter of if, but when” is very true and if anything, that is what we should be afraid of and be working to “prepare” ourselves for. I am not talking about preparation in the since of "doomsday" and creating shelters and storing food but prepare as just being generally more aware of the situations going on in the world, our countries, our communities, and our everyday lives. I think due to medications and sterilization techniques many people have forgotten that it is still very necessary to wash their hands and clean up after themselves no matter the situation. We rely on the fact that someone or something else will clean up after us too much and that has become a problem. Our dependency of antibiotics has and will continue to create a more dangerous world for the generations to come. Bacteria is adapting and become resistant to the methods of prevention we have made. What will happen when none of the scientific knowledge we currently have can combat a superbug? MERSA is currently the superbug that is untouchable by our medication and spreads likes wild fire unless it is closely under watch. I think our need to be so clean and sterile has lead us to actually be more dependent and ultimately “dirty” because we rely on hand-sanitizers and bleach to clean up our messes. I think that the advances are very beneficial but we do not need to rely on them. I don’t want to seems like an all-natural anti-science fanatic but I do think it is time we get back to letting our bodies and immune systems do what they are intended to and let us fight our biological battles without the constant need for medication. 

Quiz March 24

1. What does Paul Offit find laughable?

2. How much revenue did the rotavirus vaccine and Lipitor generate, respectively?

3. What did a Nashville woman sell for $50?

4. What did Jacobsen v. Massachussetts (1905) uphold?

5. What 20th century political philosopher does Biss's sister mention, in criticizing "Dr.Bob's" counsel of silence?

6. What paradoxical emotional state does Biss say is induced by citizenship in this country?

DQ:

• Do we have too many childhood vaccines, administered too soon (regardless of however many a child could "theoretically handle")? 110, 113
• Are there any "vaccine profiteers"? 111 Do you agree that medical researchers (as distinct from pharmaceutical companies, or their Boards and stockholders) are not in it for personal profit? 112  Do you think many private practitioners rejected a life of research mainly for personal-financial reasons? What considerations will guide your own medical-vocational choices?
• Are people who want their children to get chicken pox "idiots"? 115
• Should we respect the "conscientious objections" of anti-vaxxers? Does it matter that they "honestly believe" unfounded, unreasonable claims about the hazards of immunization? 119
• We owe the existence of this nation in part to George Washington's campaign of compulsory smallpox  inoculation, but also "owe some of its present character to resistance" to compulsion. 120 Have we achieved a proper balance between individual rights and the common good? Is balance a reasonable goal? Or would you defend tilting one way (individualism) or the other (the "general will")?
•  Is conscience easily confused with any other feeling? 122
• If "the body is such a ready metaphor for the nation," is it best conceived as an independent individual or as part of & dependent on a collective and community?
• "We have sunshine in us!" 132 Should we be more optimistic about our future health prospects?
• Is there anything wrong with understanding immune system as reflecting not only immunology but also environmentalism, alternative health, and New Age msyticism? 133

==
I was a bit surprised by the vehemence of our milk discussion last time. Guess I wouldn't have been, if I'd Googled "milk ethics" -

The ethics of drinking milk | Ethical Vegan - Compassion for ...

ethicalvegan.net/read/the-ethics-of-drinking-milk

Regular beatings, stabbings, hangings and repeated rape are all in a days work for your average dairy cow. And let's face it, if you drink milk, you're literally ...

What about Humanely Raised Milk and Dairy Products?

freefromharm.org › Farm Animal Welfare

May 3, 2011 - A mother cow's milk is perfectly formulated by nature to provide the essential nutrients and ..... Preventing Ex-Vegans: The Power of Ethics  ...

Cow's Milk: A Cruel and Unhealthy Product | Animals Used ...

www.peta.org/.../cows-milk-...

People for the Ethical Treatment of Animals

PETA People for the Ethical Treatment of Animals ... While cows suffer on factory farms, humans who drink their milk increase their chances of developing heart  ...

	Science Friday (@scifri)
3/26/15, 7:04 AM Is MSG actually bad for your health? (Spoiler: No) scifri.me/ng93mx #SciFriArchivepic.twitter.com/SCNOeYcwgk

• How many animals are experimented on in labs?
• The bioethics of googling
• Press Release | Mar. 24 on FRONTLINE: Should Vaccinating Children Be A Choice? | Press Room | FRONTLINE | PBS 

Quiz March 22

Thanks for your questions for an E.R. social worker, please keep them coming.

NOTE: The exam originally scheduled for the 29th will be postponed.
==

1. What disappointed Biss about the immuno-semiotics conference?

2. What game metaphor does Biss prefer, to describe our immune systems and viral pathogens?

3. What caused the fatal form of croup that has virtually disappeared in this country since the '30s?

4. What caused the spread of puerpal sepsis ("childbed fever")?

5. Who were the Polio Pioneers? OR, Where is polio now endemic?

6. What does Arthur Caplan see as the biggest problem with the "restaurant model" of health care? 99

BONUS: What did Andrew Wakefield do to get branded "irresponsible and dishonest" by the British General Medical Council?

BONUS: A popular theory of disease among "people like [Biss]" blames ____, rather than filth or germs.

BONUS: "Most problems will get better if left alone" is an argument for what, according to Biss?

BONUS: What's wrong with "Dr. Bob's world"?

DQ:
1. Is immunity mostly a metaphor? Is it correctly characterized by metaphors of war? Do you agree with the perspective of alt-med practitioners on this point? 57

2. Is parenting, with its attendant decisions impacting the future health of children, more "like time travel" than making health decisions for oneself? What do you make of the Star Trek example? Who in the present anti-vaxx scenario is "heroically return(ing) to the past to die"? 66

3. Why do you think women healers historically were regarded as witches, albeit "good" ones? Are women fully welcome in the ranks of professional medicine today?

4. Are there modern-day equivalents of "heroic" medicine (bleeding etc.)? Does it have a legitimate place in professional practice?

5. Are we overly obsessed with "purity" and with avoiding toxicity? Are we never cleaner than our environment at large?

*6. Should human breast milk be commodified? If so, how should it be regulated?

7. What can be done by western health workers to gain the trust of African and Muslim countries?

8. Is capitalism inherently inhumane? 95

10. Is maternalism in medicine preferable to paternalism?

Feeling Distracted or Scattered?

Join Dr. John Ratey, Harvard Medical School, to hear how to

SPARK your brain through exercise and physical activity

Mar. 21, 2016, 6pm

Student Union Ballroom

The Distinguished Lecturer Series, TAHPERD, TN Coordinated School Health, Health and Human Performance and Psychology Departments are pleased to announce a speaking engagement open to all MTSU students and members within the community that are interested in the effects of physical activity on the brain and the impact on emotional, behavior, and cognitive health.  Best-selling author, John J. Ratey, MD, is an Associate Clinical Professor of Psychiatry at Harvard Medical School and an internationally recognized expert in Neuropsychiatry. He has published over 60 peer-reviewed articles and 8 books including the “Driven to Distraction” and "Spark-The Revolutionary New Science of Exercise and the Brain." Dr. Ratey has established himself as one of the world's foremost authorities on the brain-fitness connection.  A highly sought after speaker, he has embarked on a world-wide mission to re-engineer schools, corporations, and individual lifestyle practices by incorporating exercise to achieve peak performance and optimum mental health.

==

An intervention to switch on my emotions succeeded beyond my wildest dreams, but it turned my life upside down. http://well.blogs.nytimes.com/2016/03/18/an-experimental-autism-treatment-cost-me-my-marriage/?smprod=nytcore-iphone&smid=nytcore-iphone-share

	Dr Ellie Cannon (@Dr_Ellie)
3/20/15, 4:41 PM When I say "vaccinations save lives" and you tweet back at me with some guff, here, this is for you pic.twitter.com/A1sDnoLo5q

	FRONTLINE (@frontlinepbs)
3/22/15, 8:00 PM Coming 3/24: Should vaccinating children be a choice? bitly.com/1BA1V0E #VaccineWarpic.twitter.com/MbdYbUYceM

• On the “right” to challenge a medical or scientific consensus
• Why Health Care Tech Is Still So BadElectronic records will transform medicine, eventually.
• *Breast Milk Becomes a Commodity, With Mothers Caught Up in Debate Researchers say the milk is brimming with potential therapeutic agents, for babies and also possibly adults.
• Many Doctors Who Diagnose Alzheimer's Fail To Tell The Patient - npr

Questions for an ER social worker?

I've invited a visitor to speak to our class on April 5, my sister Kim Oliver. She practices social work in an Emergency Room in Missouri. She'd welcome any advance questions/comments you might provide regarding her work there. Please post them in the replies section below.

Kim Oliver, Boone  Hospital   Center,  Columbia   MO                                 

            Emergency Department Social Worker

·         Provide social work services to patients in crisis within a multidisciplinary medical team.

·         Create individualized evaluations that address psychiatric, geriatric, protective services, hospice, home-health, mental health counseling and support. Offer appropriate community referrals and follow up care as needed.

·         Attend and participate in multiple community organizations on behalf of ED.

Scope of Practice: 

EDSW practice is guided by patient need and in collaboration with the medical team. a timely social work assessment, intervention and practice encompasses but is not limited to:

Access to Health Care

Alcohol & Drug Related

Geriatric Issues

Home Health/Hospice/DME

Information & Resources

Maternal/Child Issues

Mental Health

Protective/Legal Issues

Support & Counseling

Welcome to Lawrence, Oliver & Associates, LLC

				Welcome to Lawrence, Oliver & Associates, LLC Our goal at Lawrence, Oliver & Associates is to provide high-quality counseling, coaching and consulting services to each client.
				View on www.loacounselingan...	Preview by Yahoo

Quiz March 17

Eula Biss, On Immunity: An Innoculation 3-54

1. The stories of Achilles and the dragon imply what about immunity?

2. Our vaccines are now sterile, so anti-vaccine activists' greatest fear is not of bacterial but ____ contamination.

3. Who said love is known "by its fruits"?

4. What's the most common way that infants contract hep B?

5. Who or what were microbiologist Graham Rook's "old friends"?

6. What is variolation?

BONUS:
"A valuable asset placed in the care of someone to whom it does not ultimately belong" is Biss's definition of what? OR, it captures her understanding of what?

What is Dracula about, besides vampires?

Contributions to the "banking of immunity" give rise to the principle of ____ immunity.

What raises the probability that undervaccinated children will contract a disease?

"There is never enough evidence to prove that an event _____ happen? (can/can't)

DQ:
1. "No mortal can ever be made invulnerable." True? What do you see as the important implications of this for the issue of vaccination as public health policy?

2. Why does Biss dislike consumer confidence? What's wrong with conceiving of the public as "consumers" of health care?

3. Do you find anything sexual or vampiric in vaccination?

4. "Faith is that which enables us to believe things we know to be untrue." Is that fair? How does it apply to the vaccination debate?

5. Do you agree that one must enact and embody one's beliefs? What if one's beliefs imperil public health and safety?

6. "We owe our health to our neighbors." 20 But how do we persuade them, or ourselves, of this?

7. Have you heard anyone make the argument that public health measures are not for "people like us"? Did you construe it as covert, coded racism?

8. "Enlisting a majority in protection of a minority" is often a hard-sell in America. Is this a social justice issue, like voting rights?

9. Do you use antibacterial soap and sanitizer? Why?

10.  Comment: "It is only when disease manifests as illness that we see it as unnatural." 42

11. Should it bother us that Rachel Carson apparently was wrong about DDT being carcinogenic? 44

12. Are you comfortable with the idea of being a cyborg? 49

13. Are you disproportionately afraid of sharks and oblivious to the dangers of bicycles? Does simply acknowledging such misperceptions help you to overcome them?
==

The Panic Virus

WHO DECIDES WHICH FACTS ARE TRUE?

In 1998 Andrew Wakefield, a British gastroenterologist with a history of self-promotion, published a paper with a shocking allegation: the measles-mumps-rubella vaccine might cause autism. The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile one study after another failed to find any link between childhood vaccines and autism.

Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile millions of dollars have been diverted from potential breakthroughs in autism research, families have spent their savings on ineffective “miracle cures,” and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases.

In The Panic Virus, Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America.

The Panic Virus is a riveting and sometimes heart-breaking medical detective story that explores the limits of rational thought. It is the ultimate cautionary tale for our time.

- See more at: http://sethmnookin.com/the-panic-virus/#sthash.QarcC7dA.dpuf
==
Defending Vaccination Once Again, With Feeling-

...he really hits his stride when he turns to the social history of autism advocacy; his section on the actress Jenny McCarthy is a tour de force. To promote her 2007 book describing the purported vaccine-induced autism of her young son and his subsequent cure, Ms. McCarthy staged a media blitz, a medical tent show writ large. Blond and charismatic, she waved away the science, energized the people who wanted to believe her message (the not inconsiderable “I feel, therefore it is” segment of our society, as Mr. Mnookin puts it) and managed to do quite nicely for herself as well, netting a deal with Oprah Winfrey’s production company.

http://www.nytimes.com/2011/03/29/health/views/29zuger.html?_r=0

Midterm Report: A Good Death

Hello everyone! Jocelyn and I will be reporting on what it means to be given "a good death." The "art of dying" has been a concern spanning both era and culture. As is typical of human learning, we must first look back before we can move forward. Therefore, I will first explore historical standards of good deaths in the cultures of Western Christianity, Ancient Norse, and the Japanese Samurai. Once some commonalities emerge, we can explore how those may apply today. Jocelyn will then present the current obstacles to dying well in contemporary western medicine. Statistical evidence and the growing concern with furor therapeutics indicate the need for a death standard. In combination with modern empirical evidence and historical data, we then hope to make an argument for the ethical justification of euthanasia.

Medical Marvels

Biotechnological advances are being made every day. One of the most exciting and  groundbreaking is that of Anthony Atala. His research has contributed to the creation of materials which work with the body to heal itself in ways that it otherwise could not do on its own. These materials piece organs back together or strengthen damaged bone. With careful use of some of these products, previously thought permanent damage can, in fact, be reversed.

Even more sensational is the prospect of organ donation. Through the use of stem cells--and less controversial methods, Atala has managed to produce a functioning bladder and is working toward the production of kidneys. On stage, he presents a 3D printer in the process of creating a kidney. He says it takes roughly seven hours to print one. Imagine being in a desperate situation and hearing that your salvation--or that of someone you love--is a mere seven hours away. An organ that will be tailored to your genes, foolproof against rejection or wearing out.

While the clinical testing for these kidneys is still years away--years! Not decades!--a functioning bladder has already been created and transplanted through similar means. One of Atala’s guests is a college student named Luke, who, at the age of ten, needed a new bladder. The bladder Atala and his team created is the one that remains fully functional in the young man today:

So after the surgery, life got a lot better for me. I was able to do more things. I was able to wrestle in high school. I became the captain of the team, and that was great. I was able to be a normal kid with my friends. And because they used my own cells to build this bladder, it's going to be with me. I've got it for life, so I'm all set.

And now, with the advent of the 3D printer, such miracles can be worked in a matter of hours.

Crazier still, Atala reveals the prospect of a science fiction worthy invention. This device scans a wounded piece of the body and then layers cells, much like the 3D printer except directly onto the human, in order to heal the injury. I encourage you to watch his TED Talk to find out more:

Unfortunately, though, we cannot wait for people like Atala. His medical marvels are approaching fast but not fast enough. Every ten minutes a name, a person, a life is added to the organ donor list. Approximately 79 people will receive a lifesaving organ today. Yet another 22 will die waiting for one. These numbers are frightening, because the organ crisis is real. The demand continues to rise while the supply--at best--remains the same. (Atala’s products are still considered experimental and are therefore not acceptable in the mainstream where the need is greatest.)

This is not to say that we should all sign up to give away a kidney--though they are the most needed and most successful transplant organ. We can’t all be Ben from Seven Pounds. But we can donate blood, since every two seconds someone in the United States needs a transfusion. Or we can check a box on our driver’s license.

It’s frightening to contemplate our own mortality. And it is inconvenient to take time out of one’s day to be poked, prodded, and drained. Plus, the human propensity for the diffusion of responsibility is immense. Yet it is vital that we overcome these obstacles and cultivate our beneficence. For the need today far outweighs the aesculapian promises of tomorrow. Until the future’s genius is ready, we must remain reliant on the altruism in the present.

The Issue of Designer Babies

The idea of parents choosing the desired traits for their children (designer babies) seems appealing at first. Why not abolish de facto discrimination based on people’s height, weight, abnormal personalities, facial features, hair abundance, and mental capacity, for example. A world in which everyone was designed have optimal heath and well-being would get rid of discrimination, right?

The biggest counterargument for designer babies is that, while it would end some current forms of discrimination, it would create perhaps the most significant form of discrimination, discrimination based on genetics. Kids who don’t have the latest and most optimal genes will be regarded as fundamentally inferior, which they would be. “Natural births” and the “imperfect” children that result from them would be condemned by society for depending on the luck of nature. A world like the one in Gattaca would emerge that segregates people in two categories: the genetically superior and the genetically inferior.

Gattaca does a good job of illustrating the dangers of being too zealous with designer babies. In the film, we are introduced to a world set in the future where genomics has gotten so advanced that everyone can create a specific child, everyone can easily check anyone else’s genome, and therefore, there exists discrimination for employment based on the superiority of one’s genes. One of the positive aspects of this world are that hereditary defects are eliminated via embryonic genetic modification while desirable traits that result in superior health and well-being are encouraged; the probability of alcoholism, susceptibility to violence, baldness, obesity, along with cystic fibrosis for example, are greatly reduced while the best traits are invigorated. Other positive aspects of the Gattaca world are its easy access to finding suitable mates by knowing the unforeseen defects of future partners, to recognizing criminals based on DNA identification, and to specializing people for different careers (the pianist with twelve fingers for example).

Although there are some positive aspects Gattaca world, the negative aspect of this dystopia far outweighs the benefits: the people of Gattaca lack freedom! Everything from the school you enter as a child to the job you are hired for depends on your genome, and deviation from this status quo is very difficult (almost impossible). Another major problem genetic modification creates in this world is an extraordinary expectation of people with superior genes to succeed. This film illustrates that discrimination will always exist as you continue to try to make people the same, and that that pursuit of equality is overrated and dangerous.

Another counterarguments for designer babies is that it is inherently wrong to perceive the chance of nature as a hindrance to human perfection, rather than a contributor to that perfection. One can think of the purpose of life as being the pursuit of happiness with what (genetic and environmental strengths and weaknesses) you’ve got, and that it is completely immoral to destroy the natural lottery of human attributes because it is essential to fulfillment in life. Not having any genetic diversity and strengths and weaknesses makes life mundane and boring.

Although being able to have a “perfect” child is interesting to every parent, a whole city of “perfect” children does not seem so pleasant in any sense of the word.

Quiz March 15

1. What constrains medical intervention in nature?

2. What embryonic stem-cell research compromise was supported by Bill Frist and Mitt Romney?

3. In what way does Sandel agree with Sen. Brownback about stem cell research?

4. What does not follow from the fact that the blastocyst is "human life"?

5. Under what conditions would pregnancy constitute a public health crisis?

6. Does Sandel support a ban on human reproductive cloning?


DQ:
1. What on your view would represent "hubris" on the part of medicine?

2. Discuss: "A human embryo is a human being just like you and me."106

3. Do you worry about a "slippery slope of dehumanizing practices" inevitably resulting from stem cell research? Why or why not? 112

4. Discuss: "The distinction between actual persons and potential ones is not without ethical significance." 117

5. Do you support a ban on human reproductive cloning?

==
Stem cells at TED...
==

	Eric W. Dolan (@EWDolan)
3/8/16, 9:50 AM Toddler dies after anti-vaxx parents treat meningitis with maple syrup instead of medicinerawstory.com/2016/03/toddle… pic.twitter.com/DwrJXrkEp8

Christopher Adereti's post on "The Problem with Eugenics"

The Problem with Eugenics

The problem with eugenics may not be as noticeable when observed on the surface level: direct manipulation of one’s own genes—or that of their offspring, prevention of certain diseases, and the overall satisfaction of becoming “perfect”. But when we pause and truly assess this situation, don’t we see all the wrongs with eugenics: direct manipulation of one’s own genes—or that of their offspring, prevention of certain diseases, and the overall satisfaction of becoming “perfect”?

Despite the goods that individuals may see in such acts, I feel that the bads far outweigh them: replacing the role of God in our lives. As Michael J. Sandel states in his book, “A Case Against Perfection”, “from the standpoint of religion, the answer is clear: To believe that our talents and powers are wholly our own doing is to misunderstand our place in creation, to confuse our role with God’s.” I agree with his statement due to my belief in God and his eternal dominion over His creation. As mere mortals, I do not believe that it is morally right to give up our roles as humans and replace them with God’s role as creator of our lives.

I understand that many people would disagree with my ideals on the subject of eugenic, claiming for religious views to be removed as well as the biases that come with being too “morally” concerned when it comes to public health. Although it may be it difficult for these people to reason with my decisions, I can reason with why they feel the way they do. This falls back to my earlier statement that the fault with eugenics do not seem as bad when we take it for what it is: improvement of genes. However, the in-depth situations must be equally observed.

When knowledgably discussing eugenics, I feel that the practice can be compared with that of seeking the “perfect race”. In the days of Hitler, concentration camps were put in place to eliminate the Jewish people by killing them via genocidal procedures. What makes this mode of selecting for a perfect race any different from manually enhancing a person’s genes in purposeful attempt of becoming “perfect”? Some critics may argue that modern practices do not kill individuals the way the Holocaust did and that the long-term benefits would exceed those of the sacrifices—and while I agree, to some extent, with the former claim, I do not agree with the latter. How can an individual be sure that natural gene mutations, that give rise to new diseases, will not arise in the future and revert the decisions that this procedure removes? The answer is that one cannot predict the outcome of their eugenic decisions three or four generations past their time. In other words, I do not find it appropriate for a parent to strip their offspring of their natural right to live the type of lifestyle that they would prefer. The possibility that many additional issues could stem from the practice of genetically enhancing one’s genes—while also removing God’s authority as creator of creation—has led to my ultimate view that eugenics is not morally correct.

  

https://scientiasalon.wordpress.com/2014/05/05/the-interplay-of-science-and-ethics-the-case-of-eugenics/

https://www.lifesitenews.com/news/preposterous-pro-life-leaders-blast-un-claim-that-denying-abortion-is-tortu

The Ethical Dilemma of Premature Neonates

Doctors often have to question themselves with “Have I done enough?” However, now doctors are questioning themselves with “Have we done too much?” Over the past few decades advancement in the care of premature neonates has improved drastically. Doctors understand more now than they ever have before about the development and growth of babies. This advancement allows doctors to save premature babies up to only 22 weeks into the gestational period. That is only 2 weeks longer than what would be half of the typical gestational period of 40 weeks. Although the possibility of saving these extremely premature infants is possible, doctors have begun to question the ethics behind saving these children when typically they develop many handicaps and a poor quality of life. 

  

Babies born prematurely are extremely underweight, there skin is very thin and they are predisposed to infection, their lungs are not developed and they have breathing issues, their eyes are not developed and leave them blind, the chances of a brain bleed are high due to the lack of blood vessel development, and their intestines cannot sustain nutrients for they are also not developed. Physicians have developed ways to combat the lack of the development but long term solutions are still in need. Amongst all of these problems trying to only stay alive, extremely premature babies can be forced to stay in the hospital for months if not a year in the hospital trying to develop enough to survive and combat the outside environment. Even if the doctors can keep them alive during infancy, many of these children do not make it far into childhood. It is not that doctors want to say, “What’s the point if they are only going to live a few years?” but when thinking of the suffering and pain of the baby and their parents—as well as the extreme risks it will cost them, doctors must think holistically about the patient and families in these difficult situations.

It makes everything much harder when babies are involved in anything that could harm them. Doctors fight for children’s lives on a completely different levels than adults because children have their whole lives ahead of them. The doctors reasoning is not wrong but they have to take into consideration of the financial hardships that are to come. Not only are the hospital bills from saving premature babies lives extremely expensive, especially depending on the extent of the stay, but the after care costs have to be thought of as well. The medication, special diets, and equipment are necessary for the survival of these infants after leaving the hospital but most parents in America cannot afford them. The inability to harness the supplies causes the child’s health to suffer and leads to fatality. The quality of life in these situations really way on the minds of doctors and the question of “Would it have been better if they had just passed? That way they wouldn’t have all of this pain and suffering?”

Times Magazine has recently written an article looking into the views of parents and doctors and the miracle of saving the lives of extremely premature infants. Advancements are slowly starting to not only keep babies alive, but also it has started to help them thrive. Parents are always grateful that their children are alive and they can spend more time with them than they originally thought but it does way on their minds that their children are so sick. Scientists in the medical field are pleased with the swiftness of advancement in the field of premature infants but the time currently happening between the shifting of advancement is weighing on the consciences of physicians and medical staff.

This essay is not strictly to say that I prefer one way of thinking on this topic over another but to just inform other individuals of the thoughts and circumstances of which are incorporated into the medical field when dealing with premature neonates. I would like for this essay to be thought provoking and truly have people question themselves and their beliefs on this matter.

http://www.chw.org/~/media/Files/About/TimeMagazineArticle.pdf

http://www.cnn.com/2009/HEALTH/03/17/premature.babies/index.html?eref=rss_us

Bioethics as it relates to animal research and Aristotle's great wisdom

Recently, I attended the AAFS annual meeting in Las Vegas, which led to possible research projects among other things. With interest in a research project involving the use of dead swine, I began training in IACUC standards, the Institutional Animal Care and Use Committee which covers the USDA regulations and a host of other related standards and guides in the use of animals in research or teaching. I'm still going through a plethora of training but can clearly see the relation of this to bioethics.

One of my greatest concerns in the research I wish to pursue is the use of swine which must be euthanized for the particular forensic research in question. The research is sound and certainly important to forensics, but I have a great respect for animals and causing them harm or distress concerned me. Killing an animal for research at all concerns me, but if I must, I wanted to hope that it could be as painless and swift as humanly possible. To my great relief, the standards set out by the ethical boards and committees ensure just that. They ensure that all animals that are involved are actually required or replaced if they can be by the least sentient form of life required and the minimal number of said life forms required for the research. The pain and distress of animals involved in research is taken very seriously, which also set my mind at ease. There are strict standards and assessments to ensure this. Everything goes before a board for approval, sometimes multiple boards, depending upon the research and exactly what you are proposing to do. This helps to ensure that animals are cared for properly and that their use is taken very seriously. As I continue my lessons, I find my concerns further alleviated daily and am very grateful for the ethical boards and reviews in place. Their presence in the research allows me to plan to continue forward with this research knowing that someone will be watching over my shoulder to help ensure that I can do this without traumatizing myself or the animals I have to use, as I can assure you that traumatizing the animals would most certainly traumatize me as well.

Aristotle said that "Educating the mind without educating the heart is no education at all". I agree with this statement wholeheartedly. I am very passionate about respecting life in all forms and always have been. I raised my children in this way and will proudly state, even punished them for harming trees or plant life if they had no good, firm reason for having done so. These core beliefs made going into any science or medical related field very challenging for me, as I knew that research would lay in the path to my goals. There is no replacement yet for the "physical doing" of science when it comes to research, dissections and eventually, autopsies in learning. This is my Achilles heel or krypton in science, the use of living organisms including their possible harm and death. I will admit that I have less of an issue with parasites and insects, though they are living. It is not that I wish them to die so much as that I wish them to simply not exist anymore or at least, not near me.

Aristotle also said “I count him braver who overcomes his desires than him who conquers his enemies, for the hardest victory is over self”. I realize that we have not been studying Aristotle so much this semester, but he is by far my favorite philosopher and I find his thinking most in line with mine on these topics. I think that this quote speaks a great deal about why we need ethical boards and committees in place for research. We can become preoccupied by our research and our goals very easily, especially if it leads to a “great good” and can easily be led to believe that the greater good might overshadow the pain of a few but that would be a great mistake. I find myself often swayed by this line of thinking in many things but can always count on Aristotle to remind me that what is in my heart and soul is of great importance too. I am very grateful that a number of boards and committees are in place that understand that desire must sometimes take a back seat and that someone must ensure that we “conquer ourselves” in our quest for knowledge. I, for one, will rest easier at night in this knowledge as I continue to pursue my degree.

Ars Moriendi

Hello class. I was absent on February 2nd, and I am sure I missed out on an exciting class discussion. We discussed Chapter 4 in the first book of our course "Bioethics; the Basics." In this chapter some of the topics included clinical ethics, decision making, and medical paternalism. I understand we also touched on the topic of abortion. I would have liked to delve into this a little more; however, I understand one of our midterm project presenters will be reporting on abortion, so I will leave that to him.

I wanted to discuss the topic of Ars Moriendi. A quick refresher; Ars Moriendi is a series of two Latin texts discussing death. Ars Moriendi means "The Art of Dying." The text is written from a Christian point of view and is a result of the Black Plague taking over most of Europe. At the time it is reasonable to say that the vast majority of Europeans were faced with death in their families or friends, and we can consider the text a type of consolidation for the individuals who were afraid of death which, statistically speaking, was almost inevitable.

The following is a summary of the chapters of the "Long version" of the text titled Tractatus Artis Bene Moriendi or The Art of Dying Well Treaty. (This information is from the Wikipedia article available here.)

Ars Moriendi also had various images carved in wood that went along with each chapter

1. The first chapter explains that dying has a good side, and serves to console the dying man that death is not something to be afraid of.
2. The second chapter outlines the five temptations that beset a dying man, and how to avoid them. These are lack of faith, despair, impatience, spiritual pride and avarice.
3. The third chapter lists the seven questions to ask a dying man, along with consolation available to him through the redemptive powers of Christ's love.
4. The fourth chapter expresses the need to imitate Christ's life.
5. The fifth chapter addresses the friends and family, outlining the general rules of behavior at the deathbed.
6. The sixth chapter includes appropriate prayers to be said for a dying man.

The discussion topic available was "Can the medical profession ever fully embrace the concept of Ars Moriendi, the art of dying?"

As a future medical professional I have heard some great lectures from individuals in the field, and I have noticed a commonality between the lectures. Medical professionals tend to leave out discussion of death in their talks. Usually, especially if the audience in younger, there tends to be a question about death, and in these situations the answers are shorter and rushed. It seems that medical professionals are either uncomfortable with the concept of death, or they just don't enjoy talking about it to other aspiring medical professionals.

This is understandable in that many people go into health care in the hopes to save lives and they seldom like to think about the inevitable death of a patient. This is a major flaw in the teachings of health care in that up until medical school individuals go on believing that their career aspiration will not involve much death at all.

As a doctor, or nurse, or EMT etc. death is not something to ignore. Death is something that all life on Earth will meet and instead of evading the topic and trying to genetically distance the human race from it, it would be more beneficial to society as a whole to embrace it. Ars Moriendi served as a consolation to individuals who were frankly experiencing much more death than the average human today probably will within a given time frame. The last few chapters of the text are widely accepted and practiced in that when you are not the one dying, there is certain decorum that you should follow such as; reviewing the positives of the life, not just the end, and prayers or kind words spoken at the end. For religious (specifically Christian) individuals, many of the chapters relate to Jesus and his teachings. These chapters are still highly applicable to those who do not share these beliefs.

Similar to the discussions we had in class about relating moral decisions to a single perfect person as we do with the saying "What Would Jesus Do?" Jesus is but a vehicle for these chapters. Chapter 4 talks about imitating Jesus's life, but if you were not religious you could replace Jesus with any person you personally find moral and "perfect" and the meaning would still last.

Many medical professionals tend to discredit religious teachings and the teachings of Ars Moriendi as merely consolation to death and their job is in and of itself to keep people alive at all costs.

We understand that there are expenses associated with keeping people alive, and we understand that there is emotional chaos associated with it as well, yet our society as a whole still can't seem to move away from this mindset.

Cases show that keeping people alive is very expensive. Although this alone does not discredit the argument that healthcare workers should just prolong life and not well-being, it is important to note that this is a con.

So back to the discussion question, I do think the medical profession can embrace the art of dying (mainly because it is quite possible) but I do not think that this change will come about anytime soon, especially since no one is pushing for it to happen. We continue to perpetuate the idea that modern medicine's only purpose is prolonging life and we (because we are so afraid of death) pressure physicians in to only thinking about life and not the inevitable death.