Tuesday, May 30, 2017

Web MD

“You can’t list your iPhone as your primary-care physician.”

“You can’t list your iPhone as your primary-care physician.”

Monday, May 22, 2017

Siddhartha Mukherjee & Sam Harris on the moral complexity of genetics

In this episode of the Waking Up podcast, Sam Harris speaks with Siddhartha Mukherjee about the human desire to understand and manipulate heredity, the genius of Gregor Mendel, the ethics of altering our genes, the future of genetic medicine, patent issues in genetic research, controversies about race and intelligence, and other topics. Listen here.

Thursday, May 18, 2017

Better dead than "upgraded"?

“[Many people] are happy to follow the advice of their smartphones or to take whatever drug the doctor prescribes, but when they hear of upgraded superhumans, they say: 'I hope, I will be dead before that happens” 

“No clear line separates healing from upgrading. Medicine almost always begins by saving people from falling below the norm, but the same tools and know-how can then be used to surpass the norm.” 

― Yuval Noah HarariHomo Deus: A Brief History of Tomorrow
==
Bill Gates recommenmds Homo Deus, by Yuval Noah Harari. "I recommended Harari’s previous book Sapiens in last summer’s reading list, and this provocative follow-up is just as challenging, readable, and thought-provoking. Homo Deus argues that the principles that have organized society will undergo a huge shift in the 21st century, with major consequences for life as we know it. So far, the things that have shaped society—what we measure ourselves by—have been either religious rules about how to live a good life, or more earthly goals like getting rid of sickness, hunger, and war. What would the world be like if we actually achieved those things? I don’t agree with everything Harari has to say, but he has written a smart look at what may be ahead for humanity."

Read Bill Gates' full review of HOMO DEUS here

Thursday, May 4, 2017

Be healthy and happy, Bioethics class of '17!

Image result for the end is near cartoons
Keep in touch. Let me know how I can help you reach your goals!

Brave New World Final Blog Post: The Beauty and Negativity of Adversity


Pop warner coaches always tell their players that you grow when it is tough. Living the easy life and becoming complacent with our current situation provides little opportunity to mentally or physically grow. Even Arnold Schwarzenegger loved pain, because pain meant growth. However when life becomes too difficult, surviving is the only thing one can be focused on. It is not ideal to be focused on surviving and ignore the pleasure of life.



What is the perfect balance in our lives where it is not overly difficult but neither overly plush? Do we even have control over that balance?

Sometimes in life we are dealt a bad hand. No body can accurately predict when misfortune strikes. You are laid off, get into a car accident, or a flood destroys your home, what happens next? Most people will tell you to pick up the pieces and move on, that the experience will only make you stronger. It is true that these experiences will help you grow as a person, but if you become overburdened with unfortunate events it becomes difficult to not give up. Some might resort to alcohol, drugs, or even suicide. Who is to blame them though,

However, with modern technology and progressive policy it become easier to weather tough times. If you are laid off, there is a safety net to prevent you from starving and losing everything you have. Cars on constantly being improved on to be more safe so that if you get into a car accident you chance of death or serious injury is diminished. Even in cases of serious injury from a car accident, modern medical practices offer a better prognosis of your injuries than in the past.

In first-world countries you have more opportunity thus control over how difficult your life is. Living in a country that is more economically stable gives its inhabits a higher quality of life. Certain diseases are no longer existent and food for the most part is plentiful. Instead of worrying about how difficult life is we may be worry about how easy life is becoming. Will we becomes less motivated if our standard of living becomes too high, or will a higher standard of living provide new opportunities that were not previously achievable?

In Brave New World, life is relatively easy. Commodities are readily accessible, everyone is programmed to be complacent with their life, and if one experiences too much stress a drug called soma is taken to escape reality. Nothing is wrong with enjoying the newest item, accepting your situation for as it is, or consuming alcohol or dope when life becomes stressful. This scenario however was created with lots of influence an oversight. In a naturally progressing society, a life without adversity may not be possible.

Our standard of living 200 years ago does not compare to the standard of living today. Our ancestors may scoff at our problems today, to us however they are of no small matter. If we were to see the problems that future generations face, we may scoff at them. To some degree difficult is relative and here to stay, manifesting in different forms. However, wether we can or can not eliminate difficulty in the future, we should try to embrace adversity now.


If life gives you lemons makes lemonade.









Sorry for the late post Dr. Phil, wrongly assumed that the final blog post would be due on the exam date and not earlier.

Wednesday, May 3, 2017

The Future of Human Nature pt. 2 - The Moral Limits of Eugenics


In the first installation (which can be found here), I attempted to summarize Habermas's  thoughts on "the grown and the made." Habermas's notion here is that, before diving into the Pandora's box that is unlimited biotechnical possibilities, we should first question what we value, and what exactly we mean by "we."

A mere two sections past the previous one I covered, Habermas has stopped trying to convince us to slow our biotechnical roll. At this point, he is assuming that we're going to push the limits, and he's trying to guide us by setting moral boundaries and posing hard-hitting questions.

The section titles "the moral limits of eugenics" is the focus of part two. In the opening paragraph of this section, Habermas states his thesis in no unclear terms:

"Eugenic programming of desirable traits and dispositions, however, gives rise to moral misgivings as soon as it commits the person concerned to a specific life-project or, in any case, puts specific restrictions on his freedom to choose a life of his own." (61)

In essence, Habermas is making the case that it is never, ever morally justifiable to make eugenic modifications that may determine what an individual's life comes to be.
Genetics are an undeniable identifying characteristic that necessarily changes our lives. Whether it be height, skin or eye color, intelligence, or athletic ability- all of these things have a profound effect upon an individual. These (previously) unchangeable characteristics are what Habermas refers to as "natural fate."

He contrasts his idea of nature fate with that of the "socialization fate." The important distinction he makes here is the power of the "second party," or the party that doesn't determine the fate and is instead subject to it. The individual subject to either fate has the opportunity to correct or otherwise change the outcome of the socialization fate; however, the natural fate, as it may be determined by a parent though eugenic enhancement, is entirely inaccessible to the second party. In fact, the second party isn't even "real" in the argument, as the parents would be expected to say "who/what do we want our child to be" instead of "do we possess the moral justification to determine this individual's life?"

Habermas challenges this idea by bringing up the obvious fact: nobody consented to being born! We all are conceived, that is the way of the world- why would it matter if someone other than "fate" rolled the dice? The flaw to this (admittedly not well constructed) argument is that the "creator" is not clarified.
Human being have pondered existence since the existence of pondering. The prospect of pondering the abstract nature of a "creator" is something that all humans (at least in the Western traditions) have in common; this "freedom" wouldn't extend to those individuals "created" or selected by their parents. Instead of the pondering the abstraction of existence, they would be forced to ponder the qualitative nature of determinism (by their parents). This exemplifies the unhealthy relationship detailed above- such a one-way relationship with no compromise or opportunity for recourse is unprecedented and morally unjust.

Word count: 514

Black Man in a White Coat Installment

Jayla Moore
Black Man in a White Coat
First Installment

I’m so glad that I decided to read “Black Man in a White Coat.” Dr. Damon Tweedy does a fantastic job of narrating us through his experiences that lead up to him becoming an African American medical doctor. This book was definitely an eye opener. It’s the first book I ever read that sparingly illustrates the lack of equity in the terms of race and medicine.

In the beginning of the book, Damon expressed to us his insecurity of attending Duke for medical school. Most members of his class had graduated from ivy league colleges and were on the pursuit to graduate for another one. Damon expressed that during his first month of medical school he spent more hours studying than he had his entire senior year of undergraduate school, rechanneling his fear into determination.

Midterms came around. Damon did well on them. He scored within the top half of the class on each single exam up to that point, which proved that all his studying wasn’t in vain. His test scores made him begin to feel comfortable as a first-year medical student at Duke- or at least he seemed that way until he returned from his mid-class break. After his mid-class break, Damon re-entered the classroom and had a seat. His professor came walking in his direction, but Damon thought he was just going to walk right by him because the professor, Dr. Gale, didn’t normally socialize with students. However, the professor stopped right in front of Damon and asked “are you hear to fix the lights?” In this moment, Damon thought maybe he heard him wrong so he asked the professor if he just ask him was he there to fix the lights. With annoyance in his voice, Dr. Gale responded, “You can see how dim it is on over there on that side of the room; I called about it last week.” Damon instantly began to check himself to make sure he didn’t look out of place as a medical student. He then told Dr. Gale that the lights being dim had nothing to do with him. Dr. Gale confusingly asked him why was he in his classroom if that wasn’t the reason. Damon told him that he was in his class. Dr. Gale said, “oh” and then walked away, without saying anything else. This encounter totally turned Damon’s day upside down.

I singled out this section of the book because it hit close to home for me. I have experienced a different but similar encounter. All throughout high school, I took Honor’s English. When my junior year came around, my teacher convinced me to take college freshman English my second semester. High school students can take college courses through a program called dual enrollment. I enrolled in Dyersburg State Community College and took the course. As expected, I made an A in the course. My senior year came around and the first semester I took Honor’s Senior English and made a perfect 100. When my final semester of high school came around, I took college sophomore English at Dyersburg State. This time I didn’t do so well. I made my very first C in school. When the grades got back to my teacher he shared them with my guidance counselor. I remember everything like it was yesterday. My guidance counselor called me into her office and asked me to take a seat. As I sat down she asked me did I have any idea on why she had called me to come into her office. (I literally had no idea)! The look she gave me was very distasteful. She then slammed my transcripts from Dyersburg State Community College down on her desk and told me to look at them. What I saw saddened me a little, but I had already accepted the fact that I wouldn’t have an A or a B in that course. I had already talked to my grandparents about the course. They reassured me that I had already done extremely well as a high school student and one C wouldn’t change the world. They just wanted me to take that grade as a lesson and use that to do better in life. My guidance counselor had a completely different aspect. She was furious about that C. She chewed me out. I remember her saying “this is unacceptable, Jayla. You’ve messed up your collegiate years before even attending college. I’m sure you’ll go to one of those unaccredited HBCU’s and at this point, I’m not sure if you will even graduate from there.” It was at that point that I began to tune her out. I was hurt. My eyes began to fill with tears. My throat felt like it was tightening and it became hard to swallow. I was devastated.
Coming into college, my guidance counselor’s words stuck with me. I graduated high school with a 3.75 GPA and didn’t receive not one scholarship. I entered college acquiring student loans because my family weren’t able to pay for my schooling. Although I did not attend “one of those unaccredited HBCU’s” that she said I’d go to, I still felt like I was a failure. My grades began to show that. I come to school wanted to be a doctor, but deep down I “knew” that would never happen. It wasn’t until I read this book last year, until I gained a completely different view.


The thing that I loved about Dr. Damon Tweedy is that he never let people’s words or actions keep him down. True enough he went through some things that no one would want to experience, but he used that as fuel power to get to his next level. He overcame so much to get to where he is today. This book inspired me to let go of my evil guidance counselor’s words and shift my mindset. Now in four days, I will be graduating from Middle Tennessee State University as Jayla Moore, B.S.!!!! If you’ve ever experienced anything like this, I totally recommend reading this book!

Final Installment

Here is the link to my first *Updated* installment
                http://bioethjpo.blogspot.com/2017/04/final-project-case-against-perfection_3.html

In desperate need for some motivation, (y'all this semester was ROUGH) I looked up inspirational books and ask for the opinion of my peers and found something interesting. I went out and bought it and I haven't finished it yet but I feel better. It's called "YOU are a BADASS: How to stop doubting your greatness and start living an awesome life". Though it wasn't exactly what I was looking for, it's perks were fantastic and it ended up being something better.

Image result for you are a badass

https://www.youtube.com/watch?v=LWQEzsIFZnY

Here is a 45 minute, I know it's lengthy, video of the author basically speaking on the points of this book, how to conquer self doubt. This book is all about living life to the fullest and stop doubting your potential. This was a hard concept at first because self doubt is not something that is taught, in most situations (inserts thinking emoji), but in human nature. Being unsure of something that keeps us sane, it keeps us from making some poor choices and/or hurting ourselves.

This book is about how the author was sick and tired of just making enough money to get by, being unimpressed with her everyday life and knowing she had more potential that what she was exerting. She decides that she wants to change her life and she did. The first part of the book is talking about why we are the way we are, having self doubt. To not give the book away I will tell you only one reason, being our subconscious "Our subconscious mind believes everything because it has no filter, it does not know the difference between what's true and what's not true" (Sincero 22). That our subconscious learned all our information when our frontal lobe wasn't developed so it acts in a sense like a child.

Part two is How to embrace your inner bad ass, part three is How to get over your b.s. already and part four is How to kick ass. By these titles you can get a gist of how the book reads, Jen Sincero is witty and fun to read but really does give insightful information on how to live a new life. I started in the back of the book, starting with How to get over your b.s. already because it was the part I felt like I needed desperately at the moment. It started with "Own your ugly" *inserts shrugging emoji* I fount it hilarious and informative. I recommend you all read this book or find your own inspirational book for the summer and find a new outlook on life.

Tuesday, May 2, 2017

Treatment of Someone with a Mental Illness

     Mental Illness is receiving a lot of attention from researchers now-a-days compared to earlier times. This has led to many developments and discoveries in a more recent time. These discoveries have revolutionized the lives of many suffering from mental illnesses.
     Medication is the most common treatment for someone suffering from a mental illness, but while for many this helps there are some that is does not. Many medications act merely as a placebo for the patient. This is not saying the medication does not work, however, just that most patients are usually unresponsive to the first medication they try. there are some case that the medication was genetically incompatible with patients. One case is a 45 year old named Melissa. She was prescribed Paxil, but due to her genetics, her body broke down the medicine too fast for the medicine to help her. There is also circumstances opposite of this in which people can not breakdown the medicine and the medicine causes them severe side-effects. This is why gene analysis is becoming so important. As we are becoming able to map and view a persons genes, we can more accurately prescribe them medicine. This while still too expensive for the average person may someday be able to turn the view of medicines for mental illnesses as a placebo to a much more efficient, optimal resource.
     This theme of genetics is not only a more effective way of prescribing medicine, but this is allowing for some of the most effective research to be done on mental illnesses. While the genes themselves are not technically the causes of mental illness they shows signs of predispositions to mental illnesses. While these are not bio-markers that can definitively tell if someone is suffering from an illness there can help someone determine how to help them pre-illness possible. Since the rate of occurrence has risen so much over the years maybe doctors could check these makers as a deterrent. Mental illness is not like other diseases in which there is a clear cure. Even with the evolving medicine and other treatment many people still have a hard time living a normal life. If say they were being informed beforehand that certain types of lifestyles could be potentially bad maybe that could help them. This does not mean tell someone that a life without a constant flow of money like an aspiring artist or musician is possible bad for them so the can not do it. However, if they no something is already predisposed to be hard on them they can work harder as to not let it affect them too much. I look at it like high school teachers telling you college will be hard, so when you get to college you know it will be hard and are more prepared. It does not mean you will pass or that you are truly prepared, but it gives you the knowledge that you will have to work if you really want to do it.  
     Mental illness is something that is a hard thing to live with, but there are some silver linings to mental illness in terms of medical breakthroughs. Unlike other illnesses it does not have as high a rate of evolution. Which means scientific discoveries will last longer on treating it unlike other illnesses.


Comments:
https://bioethjpo.blogspot.com/2017/05/the-parent-child-resemblances-model-and.html?showComment=1493780188621#c5667846059230324617


https://bioethjpo.blogspot.com/2017/04/superintelligence-final-blog-post-part-1.html?showComment=1493781034329#c5638334196127351020

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Anna D. Final Post Assignment -- Part Two

On Osheroff, Medical Ethics, and a Doctor’s Duty

**I apologize for the editing because I've had to post this using my cell phone.


When Raphael Osheroff took shelter at Chestnut Lodge, a psychiatric hospital in central Maryland, he sought relief from his depressive episodes and severe anxiety that put his business dealings in jeopardy. The hospital was known for hosting prominent psychoanalysts of the midcentury era who treated Osheroff along analytic to uncover the root cause of his neurosis. His treatment team anticipated a hospital stay of at least 3 years to work out the cause of unconscious distress. Osheroff’s condition worsened, he became more agitated, he paced constantly, but his medical team refused to give him medication. 
A statement from one of his psychiatric aides expressed worry: “We are concerned about him be when looks like he is depressed, he probably is really depressed and the nursing staff feels like we have to watch him closely.” Osheroff was viewed as suicidal. However, the medical doctors viewed his issued in psychological terms and the ward administrator stated: “He asked to be put on medication but I told him it would interfere with what he came here for! I told him that he needed every neuron to absorb what we are telling him here and that medication would interfere with that. I told him that if his pacing got out of control we would have to wrap him up in a cold wet sheet pack! The social worker told us his agitated behavior was reminiscent of the obnoxious conduct that his father indulged in.”
The ethical dilemma in this instance is self-evident: Osheroff’s doctors wholly believed in their treatment plan, even considered it superior to medication. At what point is the treatment team held responsible for negligence. If Osheroff had committed suicide, could the doctors be held responsible, or could Osheroff’s mental state be blamed for his demise? I believe the medical team should be charged with negligence because medication, a possible treatment option, wasn’t even considered and the patient wasn’t showing improvement with psychoanalysis treatment solely. Osheroff was at the Lodge for seven months until a friend transferred him to another hospital. 
At Sliver Hill in Connecticut, he received antidepressant and antipsychotic medication and the patient showed marked improvement after just three weeks. Osheroff was discharged after a three month and returned to his businesses. The main point of dispute was the patient’s diagnosis; the Lodge psychotherapist argued he was treating personality disorder, specifically narcissism, and a Silver Hill’s clinician cited depression when the insurance was billed. 
When the lawsuit was taken into arbitration, the case was in favor of Osheroff; the patient’s quick recovery after medication and agony during the Lodge stay painted the psychoanalysts’ actions as erroneous, even cruel. The implications of Osheroff v. Chestnut Lodge were powerful: hospitals were now at legal risk if the treatment staff denied medication to vulnerable patients, especially if the medication had efficacious clinical trials. 
When Kramer spoke to Osheroff for his book Ordinarily Well, Osheroff  was seventy- three, and Elavil, a nerve pain medication and antidepressant, had sustained him thus far, and would for the rest of his life. 

Great piece from The Washington Post that further details Osheroff’s stay and treatment at The Chestnut Lodge

My second on Installment II: The Biophilla Hypothesis
The reasoning behind why nature is restorative is fascinating. Simply letting our executive networks take a break can bring us more mental clarity. Also puts much importance on public spaces like parks, and walking & biking trials so those should become a priority for any major city.

My first comment on Installment I: The Biophilla Hypothesis:
Great report. To echo previous comments, I certainly feel time spent outdoors is time well spent. Looking forward to reading the second installment.

Because there wasn't time fr my presentation

In the book The Spirit Catches You and You Fall Down, there was a little girl named Lia who had a severe form of epilepsy called Lenox-Gestault Syndrome. She was Hmong, which is an ethnicity of people from the mountainous regions of Laos, Vietnam, and China. Her family immigrated here in 1980 from Laos at the end of the Indochina wars. Her family move here under very bad conditions and lost children along the way. Lia had her first seizure just 3 1/2 months old. By the age of 4 1/2 she had been admitted 17 times and had over 100 outpatient visits to MCMC, the community hospital in Merced, California; where they lived.  There were numerous issues that prevents her receiving the car that she needed, most of which were a result of language barriers between her and the doctors, but also because of the vast cultural differences that exist between the Hmong tribe and American culture/views of illness and medicine. The Hmong Have animistic views of sickness where everything is a condition of the soul. Despite efforts of Doctors in America and the Shamanistic healers from their community, Lia continued to have seizures that resulted in severe brain damage and eventually coma. She lived in that state from the age of 4 1/2 till she was 30, despie the predictions of imminent death by her American doctors. The story alternates between the history and plight of the Hmong people and Lias'. The ultimate feeling I got from the book was that there are many ways to accomplish the same goals and in order to successfully exist in a multicultural environment, compassion, patence, and kindness have to be given by everyone involved.

Monday, May 1, 2017

Final Post Assignment Part 2:The Parent-Child Resemblances Model and The Child of the Famous Model from Clone Being

Two more models of analysis discussed within Clone Being: Exploring the Psychological and Social Dimensions were the Parent-Child Resemblances Model and The Child of the Famous Model. These models for Cloning look at the individual donating the genetic material having a generational gap between themselves and the clone.  This concept of differences in age between the clone the originator of the genetic material, results in unique dynamics that was not accounted for with the Identical Twin model discussed previously. Another unique dynamic to these models is that they consider the fact the originator shares genetic material with the clone, something that the Adoption Model could not consider by itself.  The first of these, the Parent-Child Model, is probably the most comparable to traditional raising of offspring.

                The Parent-Child Model looks at the clone not as an equal, like the Identical twin model, but as a genetically identical offspring to the originator of the genetic material. As such, there are several dynamics that are comparable to the Adoption Model, like the differences in generation of the originator of the genetic material and the clone. However, the main differences between the Parent-Child Resemblance Model and the Adoption model is that the clone looks like the originator of the genetic material. As such there are unique dynamics, such as the attraction to an offspring that looks like an individual, and several sections on the possibility of narcissistic parenting and the dangers possessed with such parenting styles, that are considered which distinguish the Parent-Child model from other models discussed. While these concepts are vital to understanding how a normal individual might handle having a cloned offspring, the situation can be dramatically different of the originator of the genetic material is a public figure or a celebrity.

                The Child of the Famous Model looks at the possible psychological and sociological implications of a famous, or infamous, individual cloning themselves. One possibility discussed was the concept of the famous individual donating or selling his genetic material so that individuals can have an offspring that is genetically identical to a celebrity or public figure. This would result in a situation where the clone would be indirectly famous because of the originator of the genetic material’s fame and public image. Another concept discussed was the clone’s view of the donor of the genetic material, knowing as much about the famous individual as the public and romanticizing the relationship between the clone and celebrity. Also discussed was the concept that even if the cloned was raised by the original genetic donor, the relationship would be strained due to the fame of the original genetic donor, as seen with celebrity children today. Another concept discussed involved the additional social pressures a clone of a famous individual would face from society, which could manifest in several mental disorders for the clone. Lastly the concept of the clone replacing the original famed individual after their death or retirement was discussed, bringing to light the idea of the clone continuing the legacy of the famed individual.


In conclusions, both the Parent-Child Model and the Child of the Famous Model both bring unique psychological a sociological considerations to light. While one model focuses on how cloning could affect the normal, parent-child relationship, the other model focuses on how cloning could affect relationships between celebrities, their clones, and the public at large. These are just a few of the possible outcomes that could result if cloning becomes common placed.

Word count: 575

Life with a Rare Genetic Disease: The Science, the Suffering and the Hope

Two new books — “Mercies in Disguise” by Gina Kolata and “The Family Gene” by Joselin Linder — look at how individuals cope with devastating genetic diseases.

If life can be a Hobbesian trial — “nasty, brutish and short” — then for adults with rare genetic diseases, life can sometimes be nasty, brutish and long. Take the ordinary difficulties of getting through the day and add, for example, loss of motor function, a deteriorating memory or a blocked vein in the liver and a body so swollen with lymphatic fluid that clothes and shoes no longer fit. Now throw in lack of a diagnosis and dwindling financial resources.

While the precipitous drop in the cost of DNA sequencing has helped many rare-disease patients and their families find answers they could not have only a few years ago, many more continue to embark on protracted “diagnostic odysseys” involving expensive visits with one flummoxed specialist after another. The unexplained disease brings shame, denial and sometimes blame. Along the way patients ask: Why me? It is both an existential question and a basic human desire to know oneself — to understand what is happening to one’s body. Such knowledge might lead to a treatment for, or at least, better management of the condition.

The narratives of families suffering from such diseases traffic in these questions and a roiling stew of emotions: confusion, anger, determination, resilience, love, and moments of profound despair and hope. The seeming scarcity of the last asset — hope — can make books like Gina Kolata’s “Mercies in Disguise” and Joselin Linder’s “The Family Gene” hard to read: We know at the outset that many of the characters and some of their loved ones either carry or are at risk of carrying glitches in their DNA that will cause them anguish and most likely fell them before their time... (continues, nyt)