Thursday, May 3, 2018

Installment 2 - Selwa Kanakrieh

Jehovah’s Witnesses Refusal to Accept Blood Transfusions.
The firm belief by the Jehovah's witnesses to entirely refuse to acknowledge blood transfusion; despite the seriousness of a particular situation including an emergency case, is because they are taught according to their teachings that transfusion of blood is sacred standpoint that is not up to negotiation and that if anyone has value and esteem that their life is a God-given gift they shall in no way accept blood transfusion in order to maintain their lives (Hoffman, 2016).
The Jehovah's witnesses stand with their Bible teachings which claim that blood incorporation, blood transfusions as well as blood donations and storing of their blood for transfusion at a later date, may it arise, is forbidden. This entire belief of the Jehovah’s witnesses is derived from a scripture that is different from other Christian values; thus reason as to why Jehovah's Witnesses are well known across the globe.
Jehovah’s witnesses further explain that the reason as to why they would instead not accept blood transfusions is because it is their way of showing great respect to God. This is elaborated by the fact that they are allowed to eat meat regardless of the fact that it may contain some blood. The Jehovah's witnesses, therefore, claim that the problem is not with the blood itself. Nonetheless, it is the respect and value they give to God that brought up there making this decision.  
 Organ Transplant and Judaism
At one moment opposed, Jewish practice and law on organ donation have altered dramatically, which some perceive as the beauty of Judaism as a living and evolving religion. Because organ transplantation is a very successful approach to save a life, the donation of organs has been perceived a compulsory act, a mitzvah chiyuvit, by every significant branch of Judaism. 
All the same, it is worth mentioning that some Orthodox leaders differ on the manner in which time of the death of a donor, and prefer a point later than the death of the brain. Death of the brain which results in some organs being deemed unusable but even in such an instance the kidneys, barring the disease of the kidney, remain transplantable after the demise of the donor. For that reason, not to bequeath at least a number of an individual's organs has become a sin of the mitzvah of pikuakh nefesh, i.e. saving a life.
Pikuakh nefesh which is ‘saving a life' in the English language, is a fundamental value of the Jews, and at any given time 40,000 individuals appear on the waiting list of The United network for the sharing of organs. As such, there is a question of whether to conduct a body organ while alive is a mitzvah (Messina, 2015). The answer is that as long as it beneficial and will not bring risk to an individual’s donor’s life, the removal of organs surgically and their subsequent donations such as kidneys or lungs through an alive donor is a mitzvah kiyumit, a mitzvah that should be deemed as praise-worthy but never in any way an obligatory mitzvah, because with all surgery there exists some great fear and some risk. 
In summary three verses from the Old Testament Torah (the first five books of the Bible) frame the idea of organ donation: “Thou shalt not stand by the blood of your neighbor” [Leviticus 19:16], ‘Thou shalt surely heal” [Exodus 21: 19] and “You shall restore” (an object that is lost, which is inclusive of someone’s health )[Exodus 23: 4]. The part of Judaism that refuses organ donation is against a live person donating an organ such as a kidney to another while they are both alive and is based on Leviticus 19:16. As such, there is no problem if the donor is dead.

Wednesday, May 2, 2018

Human Experimentation 2nd installment- Zach Nix


In my first installment , I posed several questions about human experimentation. However, I tried to stay fair to both sides of the argument. In installment 2 I will be stating my opinions and reasoning.
            Concerning the use of undeniably unethical research results I believe that it should be treated in a case by case manner. Much like any scientific paper the research should be reviewed for inaccuracies or bias. Simply because an individual is amoral does not mean that the results they produce are skewed, though it does warrant scrutiny. If data obtained by slaughter can save lives then it does indeed produce a “unique opportunity” that otherwise would never have occurred. As was discussed in class the use of such data can even be seen as a way to honor the dead. If the lives taken provided data that saved lives then perhaps their deaths meant more than just a war crime.
            Concerning informed consent, I agree for the most part with common practices. Although the way in which researchers attempt to convey information to subjects needs to increase to ensure that the subjects understand the study and risks more fully. Of more interest is the ethics of terminal subjects in research. If a person is desperate due to a terminal diagnosis then it is more likely they may participate in a type of test that may be more likely to end in death. Most trails on gene therapy have been targeted to genes that cause dearth early in life and many of the tests have cause the premature death of the subject. These tests understandably make one uneasy and need to be carefully monitored, but if the patient understands that they are risking a slightly longer life in return for furthering the research that may one day prevent their situation in the first place, then it is easy to see the appeal. Tests outside of the body can only tell us so much when concerning a system as complex as the human body, therefore, research such as cancer studies need willing cancer patients or the disease will never be cured. Tests such as these are the reason that any progress in medicine has been made. Small pocks or polio would never have been cured if it was not for the pioneers who risked their lives in a study or procedure that could have ended their lives.
            A more nuanced issue concerning consent is the ability of the cognitively impaired to give consent in the first place. In the case of children, it is obvious that they do not fully understand the concept of death, not to mention the difficulty explaining a procedure or test. While I generally advocate against the ability of parents to declare the desires, such as religion, of their child, children represent a huge demographic with unique traits that require their participation in tests that outweighs the issues inherent in allowing a parent to make life and death choices for a child. In the case of mentally impaired children and adults the ability to understand their own situation may not be easily determined. In these cases the specific impairment often has legal structures already in place for decision making of these individual that should be used. But if not I believe that the ethical action is to only allow for these individuals to be research subjects if, despite impairment, they are consenting when the nature of the research is explained to the best of the researchers ability and that the research requires the specific participation of the impaired demographic for proper results.

I commented on Jonathan and Joseph's 2nd installments.     

Medical Conscience (Installment 1) Katelyne Tatum


Medical Conscience
Medical conscience advocates that medical professionals can refuse to perform a service for a patient when it goes against their moral belief unless the patient’s life is at stake. Since, the Roe v. Wade verdict many conscience laws have been enacted. Starting with providing abortion-related exemptions to healthcare professionals if abortion or sterilization services go against their religious or moral beliefs. Some states have also enacted “right of refusal” laws for pharmacists allowing them to refuse to fill a prescription that goes against their religious or moral beliefs, such as, birth control or plan B. Many of the conscience laws deal with abortion, sterilization, and stem cell treatments, but with the ever-changing healthcare system and advancements in medicine these laws will continue to expand.
While a medical professional can refuse to participate in a procedure that goes against their religious or moral beliefs that professional still has a duty to ensure the care of the patient. Therefore, if a medical professional refuses to provide a service then they are obligated to allow that patient to seek medical care elsewhere without interference; refusing to give a referral, stepping between the patient and another doctor, or making a patient feel uncomfortable or ashamed goes against the patient’s right to care.
While healthcare workers should have the right to be exempted from services or procedures they do not believe in the right of the patient to have access to care also needs to be taken into consideration. Some laws, such as, “right of refusal” for pharmacist conflict with other laws; when a pharmacist refuses to fill birth control or emergency contraception it interferes with a person’s right to privacy because she is denied the right to decide to use contraception. It also can be seen as unequal treatment of men and women. Another consideration to be taken is access to care; for low-income or rural areas if a professional refuses to provide a service, let’s say an abortion, then that patient may have no other way to receive care in the area. Though a procedure may go against a healthcare workers morality, can that same person also say it is moral to leave a patient with no access to care?
               Medical conscience is good for healthcare professionals because it allows them to keep their morality while providing care to patients. But we also have to consider that there may be instances where these laws hinder a patient’s right to care. And those healthcare professionals may have to put aside their reservations for a procedure if there is no other way for a patient to receive care they need.

Tuesday, May 1, 2018

Surrogacy (Installment 2)

Surrogacy (Installment 2)
           
           As mentioned in the previous post, there are two main problems associated with surrogacy: the legality of whose child it is and commercial surrogacy. Today, commercial surrogacy will be discussed.
According to WebMD, pregnancy is an emotional rollercoaster. Many women have mood swings during their pregnancy and can experience ups and downs. Sometimes, the emotions are extended beyond pregnancy as a form of postpartum depression. Deborah Issokson, a licensed psychologist, stated, ”Motherhood is such a permanent transformation”. With that said, a surrogate mother is still a mother; she will have her emotions rampant during her nine months of having a human growing in her womb. The child that she is carrying in her womb has no relation to her in most cases. The emotional toll of pregnancy can be devastating to many mother.
A surrogate is someone will to carry a child for another, that being said, should do it out of the goodness of their hearts, a truly altruistic endeavor. The involvement of a payment for this  life-changing event, would degrade the significances of child birth to both parties. The surrogate will merely be doing a “service” for the couple. The couple would use her as a means to obtain a child. There is not an amount of money that can constitute the price of a human’s life. That being said there is no price worth the risks associated with pregnancy, the potential of complications and/or death are high, roughly 50,000 women die from complications associated with pregnancy in the United States every year. The surrogate mothers are usually socioeconomically disadvantaged, and are performing the surrogacy for monetary reward upon delivery of the child. They are usually taken advantage of by the system. The majority of the cost associated with have surrogate mother is taken by the IVF clinics that impregnate them.
           The legality of whose child it is and the downsides of commercial surrogacy is a very real thing. People are taken advantage across both parties. The complications associated with surrogacy shows how precious life is. It also show how emotional impactful give birth is. Becoming a surrogate mother is truly a rewarding feat, and should be regarded as upmost selfless acts, one that should be done for the happiness of others and not for compensation.
Sources used:
                                                      
https://www.womenshealthmag.com/life/a19972147/high-risk-pregnancy/

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Posted on Zach's and Cameron's

Installment numner 2

Solitary Confinement
In my previous post I discussed the physiological, and psychological effects of solitary confinement. In class we also discussed what a doctor, with the circumstances handed to them, would for those these patients in solitary confinement. The answers that I received were excepted, but I don't think that our opinions were from a "Doctor" stand point. What I mean by this is that I don't think that we thought, with the mindset that we took oath and saving lives is a duty that we must take part in. The more research that I have done on this topic showed me that I was no longer allowed to think with my personal feelings. As a doctor I have to think with my brain and not my emotions, I have to want the best for my patient regardless of what crime he or she has committed. I have to understand that as a doctor no matter what my everyday goal is to do what is best for my patient. With that in my mind I can't help but to think about the many people that are in solitary confinement and the amount of damage that they are going through while being in solitary confinement.

If the world was perfect and had the tools to employ more doctors. In my mind  the motto would be "rehabilitation before incarceration". What that mean is that Judges would look at the cases that are presented and based on what the charge was and the history of crime that person committed. For example, if the judge gets a case and has seen that the person has been committed of prostitution, drugs, and things of that nature. Once the case was viewed, the judge instead of committing this person of a crime he or she would make it a mandatory for this person to attend rehab, if this person doesn't then they should be sentenced to jail or prison time. In prison this person committed of the crime should still get the services of rehabilitation so that this person will be a better person when released back into society.



Now I know other things factor into play such as tax dollars that the Americans will spend, having to fix the judicial system as a whole (basically rebuild it so that people of all colors are heard). BUT if these things did spontaneously occur, I think that the "rehabilitation before incarceration"  would be an outstanding thing to implement. 
                                       
I know you guys are saying "what about the psychopaths, murders, child molesters, and rapist?!" " I  don't think they can be cured". I don't think they can either honestly. I still don't think that it's ethically right that we should put them in a cages, and allow them to get worse ( I'm thinking with the mindset of a doctor here). Here again I feel as a doctor we took an oath that basically says" the patients health is the primary focus", with the knowledge that I have on solitary confinement it is my goal to fix this situation as a Doctor. Below I  have a provided a link that kind of the same perspective of me.
                                             http://jaapl.org/content/38/1/104
                             

Hostile Architecture (Part 2)

As much as I would like to make my second post about things that are being done to critique hostile architecture, there just isn’t much that can be done. There have been efforts. Artists put spiked benches in parks that you must pay to sit on, filmmakers make videos to increase our empathy, there are public campaigns and organizations set up to help these people. Some thoughtful citizens even have set up pillows on benches, or sawed off the arm rests in the middle of a bench.

The group Unpleasant Design had an interview with the design team of Factory Furniture, which often designs public spaces based on what their commissioner asks for. When asked about how they thought society should think of homeless people, Factory Furniture responded with “Homelessness should never be tolerated in any society and if we start designing in to accommodate homeless then we have totally failed as a society.” I find this to be very true (other than the “totally failed” part, that seems a little extreme). Even though design is an incredible tool, it cannot change some of the larger problems that create the environment design is being used to shape. For homelessness, I have no solutions, but many ideas on small ways to aid the problem here and there, and maybe that’s all we need instead of a massive societal overhaul.

What I think is the important takeaway from this is that we become aware of the decisions that design is making for us, and if we are ok with them. Many of these designs end up beneficial for some, yet harmful for others. Every object we see was made with the intent to manipulate behavior in some way, sometimes in incredibly minor ways. It is of the upmost importance that everyone is educated about how our world is made as society get more and more complex, and as businesses and cities move to our smartphones next in ways that are not even tangible.


Here is the interview I used as a source in the post:
http://unpleasant.pravi.me/interview-with-factory-furniture-design-team/#more-512