Human Reproductive Cloning Pt. 2

In the last post, we discussed the background history of reproductive cloning, basic scientific knowledge, cloning techniques, and the purpose of reproductive cloning. In this post, I will focus on the pros and cons of human reproductive cloning, as well as the ethical issues associated with it.

 

 

Pros of Human Reproductive Cloning

 

1.    It can eliminate defective genes

·               Scientists believe that genetic illness can one day be a leading cause of death. When humans are reproduced, it damages their DNA lines, which creates defective and mutated genes. This problem could be resolved my cloning healthy human cells.

2.    The “Next Step” in Reproductive technology

·               Couples who are infertile, would be giving the chance to produce clones of themselves. Couples who have lost children, could be given a chance to replace their loved ones. While also people who are considered to be a “genius” could be cloned, so they world has more people who think the way they do.

3.    Can eliminate infertility

·               Infertility could be eliminated because scientists would be able to take cloned cells to create a younger twin of a father or a mother. Infertile couple would not have to go through the depression stage of not having children. They would be able to have their own families without enduring painful procedures to treat infertility.

4.    It can cure disorders

·               It can help cure certain disorders by replacing damaged tissues and organs within the human body. Scientist believe that human cloning can completely transform the way many disorders are being performed.

 

Cons of Reproductive Cloning

 

1.    It can reduce individuality

·               Although human clones would have their own brand new set of life, researchers believe you still loss a sense of having your own individual personality.

2.    It can cause a divide among people

·               Human reproductive cloning could potentially divide people, normal people from “perfect” people. It could create a societal division where “perfect” clones can be treated in a different way than those who are naturally born.  

3.    It has a lot of failure

·               90% of human cloning attempts have been labeled as a “failure” meaning the DNA is put at risk during the attempt. Human DNA can be contaminated. The implications of what happens with the Reproductive process when it goes wrong, is still unclear. This is not good and could lead to problems that are not able to be resolved.

 

Ethical Issues

 

·               Some people who have religious beliefs are against the process of cloning humans. They believe that it results in man becoming the creator instead of the higher power. Most people who value their religious belief disagree with this technology.

 

·               People also say that a clone is not a “real person”, the clone is not “natural” and the clone is “playing the God”

·               Another ethical issue is health risks to the mother. Telemetric differences can occur, as well as abnormal gene expression patterns. 98% of mammalian cloning has resulted in miscarriages, stillbirths and deformities. Safety in reproductive cloning would also result in unethical experimentation of women.

 

There are also several other ethical issues associated with human reproductive cloning. Below is a debate discussing human reproductive cloning.

 

https://www.youtube.com/watch?v=Omtn40NWk5Y

 

Commidified Breast Milk: From a Ethical View (Part 2)

In my first blog post I discussed the ethical concern of who was receiving pumped breast milk.  For this post I want to focus on the person actually supplying the breast milk. As a mother and a devout, card carrying, soap box dragging feminist this is a very touchy issue, mainly because I can go either way. Many believe that having a market for breast milk might exploit those who struggle economically by having them choose to sell their breast milk for additional income while receiving formula for their child using government assistance. Others believe that it is the woman's choice and therefore we can't dictate what she does with her breast milk, including in the scenario that I just mentioned.

I have two children (pictured above because every mom tries to sneak in a picture of her kids to show off their cuteness) and I was blessed with the ability to breastfeed them both. I adored being able to feed them and I was lucky that I never struggled to provide breast milk for them, in fact, I had an over abundance and chose to donate. Could I have sold it? Absolutely, but I chose to seek out other women who desperately needed the milk and didn't have the funds to pay for it through a hospital. Anyone have a problem with that? Probably not.

But what if I were poor? That's where we run into a tricky ethical issue. As a feminist I want to scream, "You go mama! Sell that liquid gold and make some money!" while at the same time saying, "You are not a cow! You are reinforcing gender, social, and economic inequalities!" See the dilemma?

So know that we have a established the dilemma lets talk about the solution. The other problem is that there isn't one. There are advocacy groups that address both sides of this argument, a few are the NABA, DonateMilk, and the BMBFA. When most people think about breastfeeding advocacy groups they imagine a group of women going into an establishment that asked a breastfeeding mother to cover up and staging a "nurse" in or protest, but mostly they are just trying to look out for the mothers. The executive director of BMBFA made the following statement when an Oregon based pharmaceutical company offered to pay women for their breast milk, "...it reeks of exploitation." Below is a news story were these exact concerns are addressed.

Because of the nature of this ethical issue, there will likely never be a clear cut solution or agreement on how commodifying breast milk should be addressed, but that doesn't mean we should stop talking about it.

Reflecting on the texts we've read this semester, I think the most important thing for health-care providers and caregivers to know and remember is that we are all different. We all have a different back story and different needs (physically, emotionally, and mentally) and our care should be as tailored to who we are and our needs as possibly.

Stem cells: The Great Debate

First Installment: http://bioethjpo.blogspot.com/2016/04/physician-assisted-suicide-death-with.html

One notable area of discussion is the therapeutic advancements for treatment of declining health and disease through the implementation of stem cell treatment.  Stem cells are biological cells that can differentiate into specialized cells and divide to produce more stem cells. 

Doctors, presidents and researchers have debated this exciting, yet contentious cure with an uneasy resolution.  Human cloning has sparked discontent nationwide.  Specifically, the Bush administration promoted an embryo protectionist position with executive order restricting federal funding.

Stem cells have the potential to mirror the 206 cell types in our human body.  Scientists predict one day that stem cells will be able to duplicate entire organs and serve as transplants.  In this year, a micro heart muscle was created from stem cells.  Furthermore, in May 2016, a news release states researchers are presently altering skin cells chemically into heart and brain cells through the advent of stem cells.

Adult stem cells are found in nearly every tissue and serve as a remedy in tissue regeneration.  The key proponent for bioethics is the usage of these cells in the destruction of human embryos for their vital stem cells.  Most Americans view an embryo as a human life with great moral value and with a strong ethical need for protection.  This is my personal sentiment.

There is intense bioethical issues with human stem cells for research.  The collection and use of somatic (adult) stem cells from aborted fetuses and umbilical cord blood is ongoing.  Stem cells taken from the umbilical cord just after birth involve the least risk with autologous harvesting.  These cells are obtained from one’s own body. Yet the most intense debate is on the human embryonic stem that has the capacity to evolve into different types of human tissue.    

Since 1998, these cells have been cultured from embryos giving voice to ethical judgement.   Pro-life and religious organizations have been a major force driving the policy on the future of stem cells.  This ethical dilemma will be ongoing for decades to come.

To advance stem cell science, there are alternative means of studying and utilizing the properties of stem cells.  Pluripotent (iPS) stems cells are identified as curative and do not use the destruction to human embryos.  Also, stem cells from already-deceased embryos are a possible option.  Moreover, stem cells obtained from living embryos by non-destructive biopsy and stem cells obtained from somatic cells are a future option.

Pluripotent cells are dermal fibroblasts genetically engineered to behave like normal stem cells.  Under the Obama administration, the bioethical stance is to lean toward how stem cell research can go forward instead of whether it can be conducted. 

Only recently has there been in place professional guidance for scientists to translate basic stem cell research into effective clinical applications for patients.  Today, uniform standards for cell processing and manufacture must be agreed upon by the international community of researchers, stem cell banks and regulators.  Standards for pre-clinical testing using animal models must be clarified before the human clinical trials begin, and fair procedures for enrolling humans in early stem cell clinical trials must be fully reviewed.

There is no immediate solution to the ethical application of stem cell usage in curing our many ailments in a large world of seven billion humans.  The magic in the properties of these cells is both encouraging and perplexing.  Political support will be a strong influence to allow this study to go forward.  It is definite that stem cells are restorative to our health and an option to explore with intense viability.  

Useful Link: http://www.mayoclinic.org/tests-procedures/stem-cell-transplant/in-depth/stem-cells/ART-20048117

Human Rights.. A Bioethical Issue?

Last week I wrote about bioethical issues surrounding transgender communities. A lot of arguments that are made against the advancement and acceptance of transgender individuals is that the behavior in itself is not only "deviant" but goes against typically religious, but sometime cultural, views. I want to discuss other human rights issues with intersections in ethical argumentation. Especially argumentation that involved medical views.

A clash between supports of the gay marriage movement and protesters. San Fransisco.

It seems that whenever there is a human rights issue, because of the vagueness of so many religious texts, extremists can find a way to connect whatever issue is occurring to their religion, and thus (very  incorrectly) form a personal argument against the human rights issue at hand. The impossible nature of these "arguments" are frustrating and leave the progression of society at a standstill. These issues should remain in the realm of social strife where the affects of them will, hopefully, not be life threatening. Sometimes, however, we find that human rights arguments spill over into bioethics.

When politics, religion, and medicine collide (the real melting pot that is America) the results can be catastrophic. For example in the taboo subject of abortion; the right wing of American politics is typically against the procedure whereas the left are typically pro-choice. Many arguments made for and against abortion come from a religious or spiritual standpoint. The religious and the political issues are causing a tug-o-war at the medical intersection.

Propaganda against the commodification of breast milk

In class we discussed a few topics that became heated (some quite surprisingly). Usually issues that became controversial among the students involved human rights. We found that if an issue involved medical treatment as well as human liberties they became increasingly difficult to discuss.

The abortion argument stems from a women's reproductive rights issue. Our intense discussion about commodifying human breast milk also stemmed from women's rights as well as animal rights and minority rights. Debates on "transgenderism" stem from human rights.

Because so many of the questions we face have complex histories and nuanced reasoning it is very difficult to find the best answer from a bioethical standpoint. A utilitarian approach isn't always the best especially since most medical and human rights issues are highly personalized and don't affect many people. For this reason virtue ethics may be a better option (although it is highly subjective to the person making the judgement of who is the most morally just person).

Even if the moral person chosen to be the rubric in which bioethical issues are judged with, the interpretation of that person's words and actions can also be misconstrued.

Human rights should largely be left to the individual, in my opinion, because 1) today's societal constructs are all man-made and enforced (no one asked to be a citizen of a government owned area and to make money for fear of being thrown in jail where they have even less freedom) 2) religious texts that require followers to fight any "deviant behaviors" regardless of the person's religious beliefs are usually taken out of context (and they are also not empirically verifiable and thus should not bind all people) and 3) most individuals will agree that life, despite being the longest thing you'll ever experience, is too short to be constantly stifling your interests and joys in order to please others.

To wrap this up I'd like to leave you with a quote from John Locke in his famous writing "The Pursuit of Happiness"

Who Really Knows Best? (Report #2)

            Within the patient-physician relationship, there is an underlying, mutual understanding between the two parties in which there is a sense of responsibility and obligation among them. To clarify, a health-care provide is obligated to provide the recipient of treatment a fair and unbiased opinion towards the patient's diagnosis, prognosis, and overall condition; in other words, the medical professional should be able to provide the patient with all the necessary information he/she may need prior to treatment in order to make a well-informed decision on whether or not they may want to undergo a particular type of therapy/regime. In the same manner, the patient is more or less obligated to listen to what the physician may need to discuss with them in order to fully grasp and understand how a certain procedure may affect them. The question, then, lies at which of these two groups really has the optimal/"best" say in regards to the situation at hand. Is it solely dependent on the client? provider? Or, is it a type of situation that demands a compromise between the two?

                In regards to the decision-making process involved in this issue, autonomy is a major bioethical concept that revolves around this particular topic. In the clinical setting, autonomy is defined as granting the patient with the ability to make a self-mandated decision without any external influence or coercion. The medical-provider's role in this case would be to provide the patient with all of the necessary, unbiased information in order to enable the patient to make an autonomous decision. Now, this goes without saying that confidentiality, respect for the recipient's well-being, and their right to deny or accept treatment is accounted for. For means of a practical application to this concept, take a patient who is plagued with some sort of dementia and place yourself in their shoes. Now, imagine losing the ability to properly function on an everyday basis as a result of gradually losing the ability to make simple snap decisions or remembering simple things (I.E: Brushing Teeth). Would you want the doctor to provide you with a treatment that may prolong suffering or reduce suffering based on a paternalistic approach, or would you prefer to have the ability to decline or accept that treatment based on a self-rule approach? Given that scenario, this case would best be resolved via providing the patient with the necessary information in order for them to make a well-informed, competent decision with respect to the physician's best intent for treatment.

                On the other side of this issue, beneficence is a concept that surrounds the idea of the physician's moral obligation not only to his/her respective patient but also the society as a whole. Clinically speaking, beneficence is defined as the act of ensuring that the well-being of the patient is secured and that the chance of harm is minimized among the patient and/or society. The medical-provider's role in this case would be finding a way to treat the ailments of his/her patient while ensuring that no future harm may be brought upon the society or upon the patient himself/herself. This does not simply imply that the doctor may ignore the autonomy of the patient, but it means that the physician must provide a means of treatment that is non-maleficent. In other words, the treatment must only be considered in the case that the benefits outweigh the negatives. In example, consider a situation in which an individual with early symptoms of tuberculosis is examined by a health-care provide and refuses to undergo treatment due to reasons that the individual deems as reasonable (I.E: Religious, Personal, Health etc...). Would the doctor be validated in breaking the autonomy of the patient in order to treat the individual as a means of securing the health and well-being of the patient and the society as a whole? In this case, the medical professional should continue to explain the possible outcomes of treatment/lack-of treatment to the individual with respect to their autonomy. Likewise, the patient should listen and ponder upon the 

suggestion(s) of the physician with respect to their professional role in order to make a well-informed decision.

                All in all, I think that the patient-physician relationship is one in which a mutual sense of respect and understanding is required in order for proper functionality. The two parties must both equally have an unbiased respect for each other's autonomy and knowledge base. Of course, there will be outliers to this group in which some individuals (doctors and patients) may refuse to adhere to the aforementioned bioethical concepts as it is not always easy to find a balance between them; but, the basis for whoever has the "best"/optimal say in the procedure or treatment is formed when these concepts are followed. In conclusion, after reflecting on the texts we've read this semester, I think the most important thing for health-care providers and caregivers to know or do is provide an unbiased and well-intended opinion for any recipients who may seek their assistance.

Here is a video about a physician on his view of the old vs. new doctor-patient relationship:

                                                       

Sources:

http://missinglink.ucsf.edu/lm/ethics/Content%20Pages/fast_fact_auton_bene.htm

http://www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-common-bioethical-principles/Respect-for-autonomy

http://www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-common-bioethical-principles/Beneficence-and-non-maleficence

*Link to 1st Post: http://bioethjpo.blogspot.com/2016/04/socioeconomic-status-and-patient.html*

Final solo report 2: "A human embryo is a human being just like you and me."

            Human embryos are human beings, no matter what you say a fetus is a human being. It is a living creature just like you and me even if it has not been born yet.  Embryonic stem cell is wrong because that embryo is a human just like all other embryos, even if it is to save someone else life. In the book “The Case against Perfection” Sandel wrote, “Embryonic stem cell research is wrong, he argues, because “it is never acceptable to deliberately kill one innocent human being in order to help another.” I think there should be other ways to make stem cells to help others instead of killing innocent human embryos.

            Another argument that a lot of people talk about is abortion. Abortion is the deliberate termination of a human pregnancy, most often performed during the first 28 weeks of pregnancy. Most people say abortion is wrong and I think it is wrong to because that fetus is a human being no matter what. You are killing a human because you do not want it or something. I think the only reason to have an abortion is if there is a life threatening reason. I am a Muslim and in the Islamic religion, it is actually a sin to have an abortion unless there is a life threaten reason like if the baby is born and the mom will be in a threaten condition then the mom can have an abortion, but if the mom has an abortion because she does not have the money to take care of the baby then this is a sin because God will provide for the baby.  

            There are some myths that people do not understand. Here is a list of myths:

1) A human fetus is not a human person.  The fetus in the mom’s womb from the being is breath and alive, so that makes it a living thing, which human beings are living creatures.

2) My body, my choice! The unborn child is not part of your body; it is a human being inside your body that you are carrying.

3) It is just a blob of tissue, not a baby. If you will say that a fetus is a blob of tissue then us humans are also a blob of tissue just a bigger blob. This dehumanizes unborn children by calling it a blob. Fetus are more than a blob because it has a soul, every human being has a soul.

4) Abortion is a woman’s right. No one has the right to kill an innocent child.

5) Abortion is needed to prevent overpopulation. The world is never going to be over populated.

6) Abortion is needed in cases of rape and incest. That baby is innocent and you cannot blame what the rapist did on the baby.

7) Abortion prevents poverty and suffering.

I think we should make a law that makes abortion illegal. It is so wrong to take lives because of something stupid. No child should have to be killed because the reasons above.

            I think the most important thing for health-care providers and caregivers to know or do is that human embryos are human beings. Health-care providers should inform more about human beings and how it is wrong to kill a human embryo and that human reproductive cloning is also wrong because everyone is unique in their own way.

http://bioethjpo.blogspot.com/2016/04/do-you-support-ban-on-human.html

Publicly Funded Healthcare

Pied Piper's product is its stock. Whatever makes the value of the stock goes up is what we are going to make. Maybe sometime in the future, we can change the world and perform miracles and all of that stuff. I hope we do. But like I told you before, I am not going to mortgage the present for that. 

This little gem was dropped in the episode of "Silicon Valley" that aired a few nights back. This was told to Richard Hendricks, the protagonist of the show, a programming phenom who has developed a compression algorithm with his friends in a living room that even the top tech companies couldn't beat. When investors in his company push him out as CEO, he and the new CEO struggle over the direction of the company. Richard wants to continue developing his revolutionary program, and the CEO wants to use his resources to develop whatever products will sell. Not just to generate profit, but to raise the stock price of the company.

This is what Marx referred to as the abstractions of capitalism. What is important is not the thing that is produced, but a return on investment. The fundamental goal of capitalist is the accumulation of value, and given this obvious fact it is no surprise that our healthcare system has ended up the way that it has. (See my last post) The purpose of pharmaceutical companies is not to make drugs that treat disease and disorder effectively, their purpose is to make money for their investors. The purpose of a hospital is not to treat its patients, it is to make money (even if they are non-profit; again, see my last post). The purpose of the biotech companies is not to develop technology and machinery that revolutionizes healthcare, it is to develop technology and machinery that makes a lot of money. The structure of our healthcare system is not designed to benefit the well being of the community, it is to create wealth and value.

The exception to this seems to be public funding of research and development, which is explicitly not for making money but for fostering innovation in the hopes of bettering public health. But we don't fund nearly enough, and the grant writing process has become an increasingly arduous and time consuming process Most scientists finance their laboratories (and often even their own salaries) by applying to government agencies and private foundations for grants.  In 2007 a U.S. government study found that university faculty members spend about 40 percent of their research time navigating the bureaucratic labyrinth, and the situation is no better in Europe.

 On the other hand, our Communist neighbor Cuba has developed one of the most efficient healthcare systems in the Americas. When Fidel Castro came to power in 1959, most of Cuba's resources were put into education and healthcare, and within the decade, the literacy rate and infant mortality rates were among the lowest in the world, and certainly the lowest in the Americas. At the moment, the infant mortality rate in Cuba is 4.2 per 1000, compared to 5.2 per 1000 among American whites and a staggering 11.1 among American blacks.

Cuba has also sent 124,000 healthcare professionals to 154 countries, and currently nearly 30,000 Cuban medical staff are working in over 60 countries around the world.  Similarly, Cuba trains young physicians worldwide in its Latin American School of Medicine (ELAM). Since its inception in 1998, ELAM has graduated more than 20,000 doctors from over 123 countries. Currently, 11,000 young people from over 120 nations follow a career in medicine at the Cuban institution. According to Ban Ki-moon, Secretary General of the UN, ELAM is “the world’s most advanced medical school.” He also praised the Cuban doctors working around the world, including those in Haiti: “They are always the first to arrive and the last to leave. They remain in place after the crises. Cuba can be proud of its health care system, a model for many countries."

But one of the most impressive aspects of Cuba's healthcare system is its research infrastructure. Cuba pulled off its first scientific coup with the discovery of a new vaccine for meningitis B in the late 1980s. The vaccine controlled epidemics at home, and obtained good results abroad especially in Argentina and Brazil. Although it is a small country with only 11 million people, it now boasts 52 scientific research institutes in the capital and more than 12,000 scientists on the whole island. We usually trumpet research and innovation in the United States as being the result of economic competition and profit rewards, as if it were some inherent fact of human nature that we need a profit motive to to good in the world. But we can see with the Cuban model that the more efficient model is a state run system that heavily funds medical research, community healthcare, and education. If the end goal of healthcare should be the health and wellbeing of the community, then our healthcare system should reflect that goal.

 http://www.huffingtonpost.com/salim-lamrani/cubas-health-care-system-_b_5649968.html
http://thinkprogress.org/health/2015/05/12/3657867/cuba-lung-cancer-vaccine/
http://yaleglobal.yale.edu/content/cuba-ailing-not-its-biomedical-industry 

Solo Report Part 2: Health is a Privilege

When health becomes an identity--a summation of the person standing in front of you--it becomes an easy way to feel superior. Superiority is something we all enjoy, whether we admit it or not. It’s our evolutionary instinct, survival of the fittest. We want to feel that we are somehow doing better than the person next to us.

But the problem with this is we are operating on inaccurate data. As I explained in my last post, health is a combination of factors--many of which we have no control over. Our genetics, stressful circumstances, and socioeconomic standing often have very little to do with the effort we put in. And those able to overcome all of these aspects tend to have a lot of help and plenty of resources along the way. Not always, but most of the time.

People with privilege--the privilege of health, of being male, being white--typically blame those without their advantages for the underprivileged problems. The person burdened with lung cancer was probably asking for it with a pack a day. The obese are all simply overfed and under-exercised by choice, not circumstance of course, even though genetics determines the vast majority of your weight. And those of us without these obstacles, despite what we eat or how much we exercise, get to feel good about ourselves.

But the identity of health often fails. More and more of us are succumbing to cancer. The increasing amount of sugar in everyday food multiples the risk of heart disease and adult-onset diabetes. And when it does fail, we are left scrambling to pick up the pieces of our lives. I know. I’ve seen it happen.

My father was a cop. At 6’7” and nearly 4’ wide at the shoulders, he had most criminals shaking in their boots by the time he reached the car door. He became head of the swat team, got promoted, and kept a rigid workout routine. No one would have guessed when he showed up in the emergency room for what he thought was pneumonia that the doctors would find a five pound tumor wrapped around his heart and lungs.

With his increasing amount of leave to deal with the cancer treatments and the decreasing amount of strength he had to do routine police work, he soon lost his job. Even though, he fought and won against the cancer the first time, everything he had been vanished. The identity as a vast, strong, healthy man who worked for the forces of good diminished with each injection of the poison that would buy him a few more years.

Health is not your identity. When we make it one, we add to our addiction to superiority and reliance upon its fast-fading influence in our lives. Stress management, working out, eating right, and regular visits to the doctor reduce risks, but this kind of vigilance is not readily available to all. So to some extent, yes, health is a choice, but it is mostly a privilege. And it is a privilege that cannot afford to be abused because, as Gawande points out, it’s a privilege that inevitably is revoked for us all.

Blog Post #2: Background Info on Types of Vaccines

Any time an unvaccinated child falls ill, they must inform 911, the ambulance emergency medical technicians, the emergency room staff, or doctor of vaccination status so treatment can be tailor-made specifically for them; this usually involves more testing and more doctor visits to ensure quality treatment. If an unvaccinated mother contracts a vaccine-preventable disease while pregnant, it can cause severe birth defects or even death for the baby; For instance, a pregnant mother who contracts rubella within the first trimester may have a child with congenital rubella syndrome, which causes heart defects, developmental delays, and deafness. If herd immunity is not high enough in a particular area, intentionally unvaccinated individuals are at extreme risk of contracting vaccine-preventable diseases, and they can also transmit the disease to individuals with compromised immune systems, such as cancer patients, and children who are not old enough to be given the specific vaccine. There are consequences for opting out of specific vaccines when the herd immunity is not high enough to prevent an epidemic. I will be discussing two different versions of vaccines and the history of when we didn't have the opportunity of getting immunized.

 MMR Vaccine 

The Measles/Mumps/Rubella vaccine is a live, attenuated vaccine administered at 12-15 months old and 4-6 years old. Live, attenuated vaccines are weakened versions of the classic virus, so they produce a greater immune response. If immunity fails to develop, however, the live version of the vaccine could also revert to wild-type and cause the disease it was trying to prevent. One of the most prevalent diseases seen today from opting out of this vaccine is measles. Before immunization was developed for measles, nearly everybody contracted the disease. There was an average of 450 measles-related deaths each year in the United States from 1953 to 1963. Once the vaccination was available, it reduced the contraction of the disease by 95 percent. Decreasing the rate of the MMR vaccination by opting out could potentially cause an epidemic if there aren’t enough individuals immune. Between 1989 and 1991, the number of individuals who contracted measles increased dramatically with 55,000 cases reported, 11,000 hospitalizations, and 120 deaths due to low vaccination rates involving preschool children. Contracting measles in industrialized countries can be a very serious matter. Up to 20 percent of individuals who get measles are hospitalized and 7-9% suffer from complications such as: pneumonia, diarrhea, ear infections, or develop encephalitis. Typically 1:1,000 people with measles die.

Haemophilus influenza type b meniningitis vaccine

        The Hib vaccine is a killed, purified vaccine administered at 2, 4, 6, and 12-15 months of age. A killed, purified vaccine is a protein only vaccine that contains an inactivated toxin, called a toxoid. These types of vaccines are good in a sense that they have no chance of causing disease, but the immune response isn’t as great as a live, attenuated vaccine. Before the vaccine was developed, Hib was the number one cause of meningitis in children with about 13,000 cases per year; the bacterium streptococcus pneumoniae is at the top spot for meningitis today. Before immunization, 1:200 children younger than 5 got Hib. This also killed roughly 600 children each year, and left the survivors with seizures, deafness, and mental retardation. Since 1987, when the vaccine came about, the rate of Hib has increased by 97-99 percent with an insignificant number of cases today.

              For parents looking out for the health of their child, vaccines can be overwhelming when it comes to how many your child is required to have. For the vast majority of individuals, their immune systems are built to fight off the antigens they are exposed to through vaccines, and they build immune memory to those antigens if exposed again. Without vaccines today, there would be an extremely higher number of cases for the diseases the vaccines are trying to prevent. With more parents opting out from vaccinating their children, we are starting to see an increase in the number of cases for these vaccine-preventable diseases. Vaccines aren’t always perfect, but they’re definitely worth it in my opinion. 

     

http://www.pkids.org/immunizations/vaccines_safe_choice/consequences_not_vaccinating.html
 

Final report: the problem with nursing homes prt 2

          In my last installment I covered how having one's own belongings could help with nursing homes problems and broached the subject of personal ties effecting the problems. As stated in the beginning of my previous post we as a society have come to see the elderly as similar to porcelain dolls so we feel like we should admire them from afar. This distance leads to nursing home staff to treat their patients as objects that need constant care. This conflicts with laws for nursing homes specifically about psychosocial needs, but you already know this if you read my last post.

              Now I will focus on how we can bridge the patient-caretaker gap. As I have pointed out in my last post the main reason the staff avoid getting close to their patients is  to not feel the pain of loss. We can ease this pain by accepting, as a society, that loss, death, and pain are a natural part of life. Another way to lessen the gap between patient and staff is respecting for the patients. When you have to bathe, feed, and move someone on a daily basis it is easy to how you could lose respect for him or her. However it is perimount that nursing home staff do not lose respect for their charges for once they do the charges are seen no longer as ends in themselves but merely a chore. To make these suggestions take hold I propose that nursing home staff take a class or classes that teach thought experiments where the staff are the elderly wards.

           Yet all this means nothing if the tenants don't have a modicum of freedom. As Optimus Prime said in the first Transformers movie, &freedom is the right of all sentient beings&.  However since the elderly cannot do some of the things required for daily living their freedom is limited by the amount of safety they want or need. This is a very pressing issue since to much freedom can lead to harmful accidents or death while to little would lead to a life bereft of satisfaction. Going back to Optimus's quote freedom should be granted on the bases of cognitive abilities, since self awareness is linked to sentience and ones cognitive abilities lead to self awareness. The question now becomes at what cognitive level does freedom go out the window. For me the answer is never. We should never take away the elderly's freedom entirely, the freedom to choose death, the freedom to deny help, the freedom to choose ones food, these are an example of what type of freedoms that should not be taken.

          It may seem from the tone of my posts that I dislike nursing homes, I do not. Instead I have a fear of them because my grandmother is not getting any younger and showing some signs of age related deterioration and upon reading Being Mortal I have gained these fears. My goal in writing these posts has been to articulate and address said fears, and I believe the process has eleviated them.

"We owe our health to our neighbors"

Posted for Darcy V Tabotabo

(Unfortunately the formatting and graphics were not preserved... Also check out Darcy's essay "How I Found Myself While Serving Others" in the Spring '16 Honors Magazine - the one with our classmate Bell Doski on the cover!)

We owe our health to our neighbors. This, to me, feels part of a basic human duty; rather, I would go as far to say that it is a privilege. We can do what we can to give our neighbors health as they do the same for us, what better way to improve lives and work together than this simple statement. Unfortunately, that is not the case in most scenarios today, specifically when it comes to vaccines. So it then comes to how can we convince the rest of the world that this is a necessary course of action. We can look at some examples of how looking after one another, or even working together can produce positive effects, then understand why this is necessary.

Alone, many animals are easily stalked and attacked by predators, leading to technique of predators separating singles out of a herd as a method of attack. Together, however, they are able to outnumber the predators with brute force or strength and protect one another. This is the case with vaccines and herd immunity. If everyone is vaccinated, producing immunity, then there is no host for a disease. Even if a vaccine is mostly ineffective, if given to everyone, a virus or sickness has trouble bouncing around and eventually dies out. There are also some exceptions for people who can’t take the vaccine for medical reasons or who the vaccine doesn’t fully work who are still susceptible, but because of herd immunity, they are protected from the virus being unable to reach them regardless. The problem is when fully capable people don’t have the vaccine. They not only expose themselves, but those who physically can’t take the vaccine.

There is a case saying that these vaccines may cause harm themselves in very few cases, and if this were true there would be a reasonable claim. However, any of these claims have been proven false numerous times. There have only been very few cases that would even begin to link vaccines to sickness, and

these are are not truly connected to vaccines. There is no real case as to why anyone would avoid vaccines. Rather, vaccines have helped the world by getting rid of nasty diseases that have ravaged the world for a long period of time, as seen in the graphic above. It is important for people to know the risks they put onto others by refusing vaccines. There is no real circumstantial evidence that they can cause illness and their proven success at eradicating diseases are irrefutable. It is easy for people to partake in certain activities that are proven to be harmful to themselves and still do them, and that is okay because it doesn’t effect anyone else. They understand the risks and are willing to endure them for something they are passionate about or enjoy doing. What is hard for me to grasp is that when they can do something that helps themselves as well everyone around them, there are some people who choose to take the safe route. To truly convince others, it is necessary for they themselves to look into the facts for themselves, on both sides, to understand what is true and what is necessary.

Taking this class has allowed me to see the importance of looking into things through research and through introspection as well. It is important to understand that one’s own viewpoint isn’t the only one, and there are other views that likely make more sense and more valid. My biggest take away is to step back and look at situations from every possible angle before making rash assumptions.

My first post.

Invulnerability: The Threat of Failure (pt. II)

Part I.

"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?

For starters, here's a rather to the point, article by Jeffrey Kluger on "Why 'Tolerating' Anti-Vaxxers is a Losing Strategy".

Now more fully to be addressed in this final discussion on invulnerability and immunization is the treatment of public immunity as “impossible” and what broader implications that has for public health when used as an excuse not vaccinate.

The rather binary social deconstruction of vaccination as either “wholly viable” or “totally unrealistic” seems to foster a climate of choice in which individuals can say “Well, since 100% fail-proof public immunity isn’t possible anyway, I don’t see why I need to vaccinate my kid.” But that method of thinking and that route of address comes up nothing short of horrendously problematic for the notion of herd immunity I first brought up in part one of this discussion. If, let’s say even 30% of people think either that thought exactly or something similar enough that they are convinced not to vaccinate their child, only 70% of the populace is then appropriately vaccinated. The math is simple enough. But when, according to the TIME article linked at the beginning of this post, nearer to 90% of a given population has been shown to have been vaccinated to see a clearly effective “public immunity”, we are falling more than short.

To throw it out there all the more bluntly, vaccination, while individual by nature, is not a personal matter, it is a public health & safety issue. If you’re part of the crowd thinking “well the 100% isn’t possible anyway, so there’s no point in doing this”, you’re part of the problem.

To further conclude not only this final discussion but the entire Bioethics course more broadly, in reflecting on the texts we've read this semester, I think the most important thing for health-care providers and caregivers to do is to acknowledge the inevitability of circumstance. We’ve regarded a variety of issues pertaining to manners like these: death not as a failure of medicine, but something yet to come for all of us, refusal on religious grounds to seek particular kinds of treatment, etc. The common thread of inevitable circumstance tied between these things is not something that can be fought, it is not something that results much in success or failure. That is not to say that intervention has no effect on circumstance, rather the opposite. The point I would like to make, then, is that in acknowledging that life/circumstance/choice has put this patient into whatever particular route of care they are after, there are a limited number of particular outcomes to any situation (again, some seen as successes, some seen as failures), but when the list is so limited, a health-care provider or caregiver should always address that entire list of outcomes as viable, even if some options are preferred. This is all to say more simply, while the threat of “failure” is looming, first come to acknowledge it as a possibility, and then move on to look toward intervention (medical and otherwise) as a potential to make a change in someone’s life, make a change in their situation, and perhaps make a world of difference.

Often times, surrogacy is the only option for some individuals to start a family. It is for these reasons that this process is highly controversial and key ethical issues are addressed.

A.    Attachment to Gestation mother: In a surrogate scenario, the gestational mother is the women who carries the baby for the family, the entire term. This can be a demanding process both physically and emotionally. There was a study done in its purpose to assess the emotional experiences of surrogate mothers. The study consisted of qualitative research where a systematic subjective approach was done to describe the life experiences. The subject included eight women aged 29-34 years old, all participants had children.

Experience acquired in pregnancy:

1.      Feelings toward pregnancy: Coercion having no feeling to baby

-          All participants stated that they tried to have no motherhood feeling to the child inside their womb. “That baby would never belong to me,” stated one of the participants.

2.      Doubt about informing own children of the pregnancy type:

-          One participant stated: “I have a little girl who is very smart and understands many things so I did not know how to tell her. She frequently asked: "Mom, do you want to bring me a brother or a sister?”. I could not really explain it to her. I did not know what to say.”

These are just a couple of the emotions that the surrogate mothers were feeling. This is not to suggest that the results of depression in surrogate women are higher in general population. Most importantly, there should be more factors included when deciding to be a surrogate mother. The study shows that more attention should be paid to choosing suitable hosting applicants with professional counseling before pregnancy, Detachment is important in surrogacy, whether the surrogate showed mental capabilities in the beginning.

B.     Breach of Contract: Either party, whether it be the intended parents or the surrogate mother can breach their contract.

Definition: a legal cause of action in which a binding agreement or bargained-for exchange is not honored by one or more of the parties to the contract by non-performance or interference with the other party's performance. (google.com)

-Voluntary abortion by the surrogate without consent of the intended parents.

- Surrogate can breach the contract by failing to follow certain behavioral restrictions (alcohol/drug consumption).

-Failure of intended parents to pay for all expenses and fees.

C.      Ethical Issues (My View): Surrogacy can be considered a baby selling process to a certain extent. I feel as though, surrogacy cheapens the value of human life to create a child and shop the surrogate around looking for someone willing and able to pay the cost. Not saying all experiences are the same. In some instances, you have families that would rather have their family members carry their child, rather than some women through a surrogacy company. This is an extreme case because it raises thoughts of sincerity, detachment, and distress on both parties. I think all possible options should be considered. Looking out for both the intended family and surrogate, it is a very touchy situation. If this is the last option, more research should be done. In some U.S. states surrogacy is considered favorable, surrogacy parent contracts are forbidden, etc. Question: To be a surrogate or not to be?

*Link to study*: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126251/

Time & memory, and Alzheimer's, and pot

Time and memory have much to do with happiness -


Two millennia after Seneca’s acutely timely treatise on how to extend the shortness of life by living wide rather than long, Marc Wittmann examines the psychology of expanding our experience of time:

In order to feel that one’s life is flowing more slowly — and fully — one might seek out new situations over and over to have novel experiences that, because of their emotional value, are retained by memory over the long term. Greater variety makes a given period of life expand in retrospect. Life passes more slowly. If one challenges oneself consistently, it pays off, over the years, as the feeling of having lived fully — and, most importantly, of having lived for a long time. (continues at brainpickings.org)

...hence the tragedy of Alzheimer's...

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And did you see this morning's feature on CBS Sunday Morning -