Patient H.M. & McGee's Bioethics

	Glenn McGee (@glenn_mcgee)
2/12/17, 4:55 AM "...the single payer is you" newyorker.com/humor/daily-sh…

NEW HEALTH-CARE PLANS AVAILABLE UNDER DRUMPF

By Sam Weiner February 10, 2017

PLATINUM

For a monthly premium of two hundred and fifty thousand dollars, this plan gives you prime access to all health-care options—no referrals or medical ailments required! If you’d like an MRI just for the fun of it, you’ll be slid into the very next available magnetic scanning tube. All prescription medication is free, plus the pharmacist has to say, “I love you; you are my moral superior,” when you pick it up.

GOLD

The same as the Platinum Plan, but only available to people who own a gold mine.

SILVER

For the incredible price of just $49.99 a month, you’ll receive a five-hundred-millilitre bottle of an unbelievable liquid miracle cure containing nanoparticle colloidal silver! Just one tablespoon daily will boost immune-system strength, make skin look decades younger, and improve your performance in the boardroom and the bedroom.*

*A study conducted by the Colloidal Silver Foundation of Orlando confirms colloidal silver’s effectiveness. Patient Todd S. reported, “After I started taking colloidal silver, my necrotizing fasciitis cleared up and my blood has skyrocketed in value because of all the silver in it!”

BRONZE

You can see any doctor in your network for only a ten-dollar co-pay. Your deductible is forty million dollars.

CADILLAC

A man in a top hat will throw a crumpled-up hundred-dollar bill at you if he hits you with his Cadillac. (Not to be confused with the ROLLS ROYCE plan, in which your decrepit body will be rolled up into a carpet and sold to a man named Royce.)

TURQUOISE

Only when your lesions turns this color will you be allowed to see a doctor.

REASONABLY AFFORDABLE OPTION

This plan features small co-pays and a low deductible, and allows you to see out-of-network specialists for the in-network price with just a single referral. This shockingly fair option is listed here because decades of social patterning have taught poor people to skip the top half of any list ordered by price.

WOMEN’S EMERGENCY PLAN

If you’re a woman who needs quick and compassionate help with family planning or contraception, this taxpayer-funded plan allows you to see any in-network priest.

BAUXITE

Only covers catastrophic injuries. Only lets you visit a veterinarian.

FELDSPAR

No health care will be provided to you, but nurses will remind any living relatives to mourn you.

AMETHYST

If you often require medical assistance but can’t afford to pay a lot, this plan lets you see—whenever, wherever, and however often you need—a photograph of a doctor. (You will need prior authorization if you prefer to look at a picture of a dog wearing a stethoscope.)

GRANITE

Free pickup of your carcass from the gutter after your death.

GRANITE+

Includes all the features of the Granite Plan, plus a guarantee that you’ll be buried in your own grave.

DIAMOND

You pay nothing up front. You pay nothing later. You receive the highest quality medical care available. No matter what happens to you, you will never die. However, as the centuries pass, you will discover that immortality has its own price.

SINGLE-PAYER

A single payer covers the entire cost of your health care. The single payer is you.

==

The nyt magazine’s Ethicist columnist on self-administering an untested therapy, lying to your dementia-afflicted mother and unequal pay:

Can a Researcher Studying an Alzheimer’s Treatment Try It on Himself?

I’m an older scientist who has spent decades leading a small laboratory at a well-known medical center. Much of our work is purely for the joy of discovery, but we also seek badly needed cures for illnesses. A cure for Alzheimer’s disease is beginning to look attainable with technology we are pioneering. While investigating genes for early-onset Alzheimer’s, we invented a gene-transfer method that stopped the brain damage and restored cognitive function. Eureka! Sadly, my doctor has just given me a diagnosis of early-stage Alzheimer’s. Given that no truly effective treatment is out there yet, can I try dosing myself with our potential cure? Do I have the right, given that I will otherwise die of dementia before a clinical trial could even begin? I plan to do this alone. None of my people will know about it. It’s something like a high-altitude, low-opening jump. It is not reversible and may be dangerous. But is it wrong? Name Withheld

I’m sorry to hear about your illness. As our diagnostic capacities regarding dementia increase, more and more people face this distressing news. That makes the work you are doing especially important, and I’m glad that you have hopes for the approach that your lab is studying. I can see the temptation you face.

What’s more, the history of medicine is full of cases in which researchers experimented on themselves. Salk gave himself his polio vaccine before it was given to the public. The inventor of Valium tranquilized himself before tranquilizing the multitudes. Barry Marshall, the researcher who identified Helicobacter pylori as a cause of stomach ulcers, gagged down a bacteria-laden broth and studied the results. One reason this practice was permissible — even heroic at times — was that because the subject was the experimenter himself, informed consent wasn’t an issue. There are obvious limits to such “n of 1” case studies — an anecdote isn’t data — but knowledge has sometimes been advanced this way.

Because you are entitled, in my view, to take your own life if you have normal mental competence, you have the right to risk your own life, especially in the interest of improving the quality of your remaining years. And if having subjected yourself to this experimental treatment, you experienced drastic improvement and revealed what you’d done, it’s conceivable that you could help accelerate the process of moving the therapy to clinical trials. (Or not: Early dementia can be episodic, and its progression may lack a fixed course.)

(continues)

==

Zoltan Istvan ran for president with a modest goal in mind: human immortality.
==

	Peter Boghossian (@peterboghossian)
2/11/17, 10:09 PM Even by 2017 standards, this is deranged. twitter.com/GodDoesnt/stat…

Republican lawmaker in Tennessee proposes bill designating children born via artificial insemination "illegitimate."

http://m.wmctv.com/wmctv/db_401748/contentdetail.htm?contentguid=7SiQ7uv2 …

==

A national physicians’ group says back pain is treated best by exercise, massage therapy or yoga and over-the-counter pain relievers, not medications like opioids

Added to the problem are the incentives that push doctors and patients toward medications, scans and injections, Dr. Deyo said. “There is marketing from professional organizations and from industry,” he said. “‘We have the cure. You can expect to be cured. You can expect to be pain free.’”

Medical insurance also contributes to the treatment problem, back experts say, because it does not pay for remedies like mindfulness training or chiropractic manipulations which, Dr. Deyo added, “are not cheap.”

Even if doctors want to recommend such treatments, there is no easy referral system, Dr. Atlas said.

“It is much easier at Mass General to get a shot than to get a mind-body or cognitive behavioral therapy,” he added.

Dr. Weinstein has a prescription: “What we need to do is to stop medicalizing symptoms,” he said. Pills are not going to make people better and as for other treatments, he said, “yoga and tai chi, all those things are wonderful, but why not just go back to your normal activities?”

“I know your back hurts, but go run, be active, instead of taking a pill”... (continues)

==

Here is a link relevant to comfort care:

http://www.latimes.com/local/lanow/la-me-ln-foster-father-sick-children-2017-story,amp.html

Mohamed Bzeek is a foster parent who cares only for terminally ill children, continuing his late wife's passion. It's an incredible but saddening article that I hope will take time to read.

Good health news, & Randy Pausch

Lessons on Aging Well, From a 105-Year-Old Cyclist

At age 105, Robert Marchand, a French amateur cyclist, is fitter than most 50-year-olds, and appears to be getting fitter with age...

Global Health: Turning the Tide Against Cholera
Well: How Meditation Changes the Brain and Body
Weak Reporting System Let Risky Surgical Device Stay in Use
Plain Old Vaping Gives Way to ‘Dripping’ Among Teenagers, Study Says
Trump’s Travel Ban, Aimed at Terrorists, Has Blocked Doctors
Misophonia Sufferers: Scientists May Have Found the Root of Your Pain
Well: Is the Sleep Aid Melatonin Safe for Children and Adults?
Well: The Close Ties Between Exercise and Beer

My Midterm Report: Ethical Issues in Genetic Testing.

Hi guys,
Sorry I didn't get the chance to meet you in person. However, I thank Dr.Oliver and you too for letting me do my report online and keep in touch with you. I decided to do my report on "ethical issues in genetic testing."

Why may Genetic Testing lead to Ethical Dilemmas? 
Why is genetic information special? 
Should the information be obtained if no treatment or intervention exists?
Discussions about ethics are important in many aspects of health care but are especially critical when the health care includes genetic testing. There are several aspects of genetic testing that may lead to ethical dilemmas (e.g., the limitations of what genetic testing can provide in specific clinical situations).
Genetic information is often considered exceptional when compared to other medical information about an individual for a number of reasons:
1-The shared nature and ownership of genetic information:individuals undergoing genetic testing have a responsibility to consider not only what it means for their own health, but also what the information may mean for their relatives, and their responsibilities towards those relatives.
2-Limitations of genetic testing:While in some cases, genetic tests provide reliable and accurate information on which people can make decisions, in other cases it may not be possible to obtain a definitive result. An individual is much more than the sum of their genes: the individual’s environment can modify the expression of genetic messages to the body and many health factors are not genetic.
3-Setting boundaries in applications of the genetics technology: Moral, religious and cultural beliefs underpin decision making by individuals, couples, families and communities and may challenge such boundaries.

After we saw how the genetic information is special, let's discuss the ethical dilemmas that may raise from the genetic testing.
1-Limitations of genetic testing:
Genetic testing creates important opportunities for assessment of genetic risk and diagnosis. However, some genetic tests do not identify all of the possible gene mutations that can cause a particular condition, or they have limited predictive value.[17] Because some genetic tests may not provide all the information that families may want, the test may subsequently require difficult decisions without providing full information. This can lead to uncertainties for patients and clinicians.
2-Undesired options after genetic testing:
Prenatal genetic screening is commonly used to identify pregnancies at high risk for birth defects, including neural tube defects and genetic conditions such as Down syndrome.
3-Uncertain Implications for Early Intervention:
Another growing clinical application of genetic testing is identification of the genetic contribution to risk for common diseases to guide early intervention and preventive care. Genetic testing for mutations in genes associated with hereditary breast/ovarian cancer is an example of a genetic test that can identify individuals who would benefit from individualized screening and prevention protocols based on their genetic susceptibility to breast and ovarian cancer.

Case To Study:
Huntington disease (HD) is a neurological degenerative disease that has an onset in most people between the ages of 30 and 50. There is no cure for this condition and it is progressive. Symptoms include deterioration in movement, cognition and generalised functioning. Death usually results from respiratory illness.
HD is an inherited condition. A child of an affected person has a 50% chance of inheriting the faulty gene that causes the condition. Genetic predictive testing is now available for persons over the age of 18 who have an affected parent or relative which will tell them in almost all cases whether they will develop the disease at some stage in their life.
Mr H. is a 25 year old man whose grandfather died some 10 years ago from Huntington disease. Mr H’s mother has therefore a 50% chance of developing HD. She decided to have the genetic test and has been shown to have the faulty gene. She will definitely develop HD at some time and Mr H is now at 50% chance of developing HD.
Mr H. is an air traffic controller. He loves his job and he feels he could perform his duties most adequately for many years, irrespective of whether he carries the faulty gene for HD or not. He does not wish to have the genetic test. His employer is unaware of his family history.
Questions and Dilemmas:
1-To know or not to know? When is the right time to decide to have predictive/presymptomatic testing?
2-Who actually ‘owns’ this information and who should decide who can access it?
3-What if the situation was reversed and Mr H wanted testing but his mother had refused? What responsibility is there to offer testing to an individual when the result may indirectly reveal the genetic status of a relative (if Mr H carries the HD gene fault then he must have inherited from his mother)?
References:
Ethical Issues With Genetic Testing in Pediatrics. June 2001, VOLUME 107 / ISSUE 6
Journal of Medical Ethics. Ethical issues in predictive genetic testing: a public health perspective.
http://www.medscape.com/viewarticle/505222_4
http://www.genetics.edu.au/Publications-and-Resources/Genetics-Fact-Sheets/FactSheetELSI
http://www.genomicslawreport.com/

Bioethics News

This link is a good one I found to use to explore more topics about bioethics and its recently issues and topics.
http://www.bioethics.net/news

"How the Anti-Vaxxers Are Winning"

It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America.

Measles is one of the most contagious and most lethal of all human diseases. A single person infected with the virus can infect more than a dozen unvaccinated people, typically infants too young to have received their first measles shot. Such high levels of transmissibility mean that when the percentage of children in a community who have received the measles vaccine falls below 90 percent to 95 percent, we can start to see major outbreaks, as in the 1950s when four million Americans a year were infected and 450 died. Worldwide, measles still kills around 100,000 children each year.

The myth that vaccines like the one that prevents measles are connected to autism has persisted despite rock-solid proof to the contrary. Donald Drumpf has given credence to such views in tweets and during a Republican debate, but as president he has said nothing to support vaccination opponents, so there is reason to hope that his views are changing.

However, a leading proponent of the link between vaccines and autism said he recently met with the president to discuss the creation of a presidential commission to investigate vaccine safety. Such a commission would be a throwback to the 2000s, when Representative Dan Burton of Indiana held fruitless hearings and conducted investigations on this topic. And a documentary alleging a conspiracy at the Centers for Disease Control and Prevention, “Vaxxed: From Cover-Up to Catastrophe,” has recently been shown around the country.

As a scientist leading global efforts to develop vaccines for neglected poverty-related diseases like schistosomiasis and Chagas’ disease, and as the dad of an adult daughter with autism and other disabilities, I’m worried that our nation’s health will soon be threatened because we have not stood up to the pseudoscience and fake conspiracy claims of this movement... (continues)

A Hobbesian Take on Disease Pandemics

The English political philosopher Thomas Hobbes’ social contract theory of society, very simply, states that humans form a contract with other humans, giving up EVERY natural right that they have in order to preserve their own life and stay out of the natural state of war that human kind has a strong affinity for. The only natural right that they cannot give up is their right to preserve their life as best they see fit.

            So how does this tie in to disease pandemics? As discussed in the book, the tricky part of preventing and controlling disease outbreaks is having to balance how much personal freedom you take away from an individual so as to protect the rest of society. For Hobbes, it would appear that because you entered into a society and “signed” the social contract, you forfeited all of your rights in order to stay alive, just as everybody else did (theoretically at least), so you must submit to the quarantine in order to protect the lives of everybody else in society.

            However, I feel it is important to note here that Hobbes might say that this only applies so long as your life is not being threatened (more than it already is, considering you have some sort of a highly contagious disease). This means that a government could not tell you “Unfortunately you have the Bubonic Plague, so we are going to have to shoot you and burn your body.” I feel as though Hobbes would say that you now have the right do anything necessary to protect yourself, as your one unalienable right has been infringed upon.

 271 Words

An Alternate Quiz Question

T/F: John Snow discovered that the highest incidence of cholera was in the Soho district of London around the water pump.

Alternative Quiz Questions: Ch 6 Justice

1. What English city was mentioned to be the starting point of public health ethics due to massive outbreaks of cholera in the nineteenth-century? (138)

2. What are the ethical issues revolving around the use of screening? (139)

3. What is likely to occur if too many parents refuse to have their children vaccinated? (140)

4. At the extreme end of health promotion, what policy prohibited certain groups of people from having more than one child in order to slow down the rapidly increasing population size and what were that negative results of this policy? (141)

5. What has modern medicine fallen victim to? (144)

6. How does the parable Campbell told at the beginning of the "Inverse Care Law" section signify one of the problems in health are allocation at the 'meso-' level? (147)

7. How does the second principle, based on the scenarios created by Campbell, cause a issue for the life boat scenario? (155)

8. Why does philosopher John Rawls argue that differences in income and society status are inevitable and even desirable in a free society? (158)

9. What is the difficulty behind making the WHO approach to global health inequity a reality? (161)

10. What does the image of the instinctive flock behavior of birds suggest that we should be hopeful for in regards to health care? (164)

"When Breath Becomes Air" Readings, quiz, and discussion questions.

Quiz

1. What type of cancer was Paul diagnosed with?
2. Paul said severe illness wasn’t life-altering, it was ____________.
3. Why were the doctors worried about pneumonia?
4. Instead of intubation, what could Paul choose?
5. What was Paul’s wife’s way of recreating home while in the hospital?

Discussion Questions

• Is it ethical to withhold Paul’s diploma from Medical school if he can't handle a full workload as a chief resident because of his lung cancer?

• Did Paul do the right thing by going back to work once he got healthier?
• Was it fair wanting to have a child, when Paul knew that his health was in jeopardy?
• When we are faced with someone who is dealing with grief, what is the best way to go about helping them?
• Is it easier telling an older individual that they are going to die versus telling a younger person?
• If you were Paul, would you want to be intubated at the end of your life? Resuscitated?  

Lucy Kalinithi... "My Marriage Didn't End When I Became a Widow"... pdf download... goodreads

When Dr. Paul Kalanithi sent his best friend an email in May 2013 revealing that he had terminal cancer, he wrote: “The good news is that I’ve already outlived two Brontës, Keats and Stephen Crane. The bad news is that I haven’t written anything.” It was a jokey way of dealing with the unthinkable but also an indication of Dr. Kalanithi’s tremendous ambition. He had led a fascinating life and was not about to leave it unchronicled.

The bittersweet news is that in the 22 months left to him, Dr. Kalanithi, who died at 37, went on to write a great, indelible book, “When Breath Becomes Air,” that is as intimate and illuminating as Atul Gawande’s “Being Mortal,” to cite only one recent example of a doctor’s book that has had exceptionally wide appeal. To paraphrase Abraham Verghese’s introduction, to read this book is to feel that Dr. Kalanithi still lives, with enormous power to influence the lives of others even though he is gone.

Dr. Verghese suggests not only reading “When Breath Becomes Air” but also listening to the overwhelming response it prompts in you. I guarantee that finishing this book and then forgetting about it is simply not an option. There is so much here that lingers, and not just about matters of life and death: One of the most poignant things about Dr. Kalanithi’s story is that he had postponed learning how to live while pursuing his career in neurosurgery. By the time he was ready to enjoy a life outside the operating room, what he needed to learn was how to die... (continues)

Alternative Quiz Questions: Ch 6 "Justice".

What are the different spheres of justice that Campbell defines?137-138

Back to the nineteenth century, what was the popular medical theory of the time? 138

What was the purpose of "Screening"?

(T/F) Vaccination does guarantee immunity.

Why the proportionality between harm and benefit must be maintained? 141

What "Grim Reaper" advertisements mean?142

What kind of differences justify unequal treatment in healthcare? 143

What are the differences between macro, meso and ,icro allocation? 145

What is the most powerful factor in ill-health? 146

What are the principles for just health care?155

what are the two fundamental principles of justice by Rawls?158

What is the maximum principle? 158

Alternative Quiz Questions: Ch4

What Bernard Shaw means by "A conspiracy against the laity" in his book "The Doctor's Dilemma"?79

What does G.B.Shaw means by a way of gaining personal advantage? 80

Why the first consideration of the health professional must always be the best interests and welfare of the patient? 80

What was the Geneva Code of Medical Ethics statement in 1948? 80

What Campbell means by "Best interests"?83

(T/F) People should be treated as though they were merely examples of a disease. 83

What are the three keys features of valid consent?

(T/F) Roman Catholic Church believes that embryo isn't a person. 89

Describe the analogy of the violinist and how it relates to abortion. 92

What Commodification means? 96

What is the other name of regenerative medicine? 99

Alternative Quiz 5

1. What does The Helsinki Declaration requires that all research protocols do? (117)
2. What does IRB stand for? (117)
3. What is the 'therapeutic misconception'? (119)
4. What did W.T. Summerlin do? (126)
5. What is the term used for copying another person's work without acknowledgement? (126)
6. Ghost writing is an example of what? (127)
7. What is physical enhancement? (130)
8. Who reported the 10/90 gap? (135)
9. What is one way to reduce the 10:90 gap?
10. Name one of the further readings Campbell suggested. (135

Alternative Quiz Questions: Ch. 5 Research

1. Due to the scandals of research experiments in the past, there is now world wide agreement that all research involving human subjects must be what? (116)

2. Some countries, such as the UK, make their ethics committees part of the regional or local organization of health services. What are the benefits and issues with this arrangement? (117)

3. The Nuremberg Code stated that consent must be gained in all experimentation with human beings; however, if this was strictly upheld, what groups of people would be excluded from health research? (119)

4. What four different areas of research does Campbell consider in this chapter? (121)

5. What are some of the several different forms of misconduct in research? (126)

6. What does Campbell say we all hope biomedical research would rid itself of? (129)

7. What was it that novelist Aldous Huxley foresaw in his book Brave New World? (130)

8. How does Campbell say biobanks hold an enormous potential for global health research? (134)

Ch. 5 Discussion Question: Transhumanism

Toward a Transhumanist Future

The transhumanist movement finds itself at the "extreme end of the quest for human perfectibility," looking forward to a future of perfected post-humans. Some transhumanists foresee post-humans extending their lives to eternity by downloading their minds onto computers.

An episode of the science fiction television series Black Mirror (available on Netflix), entitled "San Junipero" explores such a future. In this episode, "In the present-day real world of the 2040s, the consciousness of the dead or dying can be uploaded into a simulated reality system, where they can live in the fantasy town of San Junipero as their younger selves forever. Living people can visit San Junipero for trial periods but are limited to five hours a week." Forbidden lovers have to make the moral decision of whether or not to spend eternity together, despite lost family members.

Though the post-human future is still a matter of science fiction, I would like to pose the following discussion question:

Would you upload your mind to a place like San Junipero after your death? How far is too far in the effort to extend human life through biotechnology? When does the effort become playing God?

Optional Alternate Quiz Chapter 5

1. Who wrote, "I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail."(115)

2. The________  __________ requires that all research  protocols must be submitted to a "research ethics committee before the study begins". (117)

3. What is one issue that is controversial in research development? (118)

4. What is a Randomized Clinical Trial? What is it suppose to do to ensure scientific validity?(121)

5. The __________ approach seeks to minimize both the suffering inflicted on animals in medical research  and the number of animals used(or killed). (123)

6. What is the term for giving credence to the idea that "it's all in our genes"? (124)

7.What are two examples of fraudulent authorship?(127)

8. What is sponsored by the US Public Health Service in order to inhibit scientific fraud?(128-129)

9. Transhumanism  finds support in which two theories?(131)

10.What is a "biobank"? How is it useful? (133-134)

Human Cloning and Religions.

"When religion is not influential in a society or has ceased to be, the state inherits the entire burden of public morality, crime and intolerance. It then must use punishment and police. Yet this is unsuccessful as morality, integrity and self-respect not already inherent in the individual, cannot be enforced with any great success." That quote shows us how religious influence in society plays a vital role in people's life. Furthermore, some theologians declared this religion is the main source for morality. For that reason religion has influenced the society in the past on how it is supposed to act toward such a specific scientific evolution, for example cloning. Religion is among the most powerful factors shaping attitudes toward human reproductive cloning. However, as science moves forward, the challenge to religion increases. I actually see how religions look like has no more power and dominion over nations as before. In religious view, cloning is wrong because it directly challenges the authority of the Lord: "Cloning humans is Science presuming to have rights that belong only to our Creator." "It is not up to humans to clone themselves, it is up to the Lord, who made what he wanted to make." As many Christians do not believe that God intends for humans to create other humans. Some respondent proclaimed, "Cloning should be limited to medical reasons only, and only allowed to continue so far. Anything else will disrupt the natural process of nature: birth and death."
In short, that stresses the capacity of religion to resist the secularizing influence of science. The controversy over cloning in part illustrates the possibility of heated future conflict between religion and science.
References:
A Scientific Study of Religion by J. Milton Yunger, Oberlin College.
http://jetpress.org/volume13/bainbridge.html
http://www.freedommag.org/issue/201412-expansion/l-ron-hubbard/religious-influence-in-society.html

Midterm group reports

Review the roster of midterm group reports and supply any missing information. If your group has difficulty procuring your first choice of texts, I suggest a visit to the library ASAP. Go to the 2d floor stacks, and browse the Bioethics section until something grabs you. Or come by my office during office hours (TTh 11-1, 300 JUB) to borrow one of my books for your report.

All presenting groups: assign and make available 10-20 pages from your main text for the whole class to read at least three days PRIOR to your designated reporting date, and post a quiz about it AND at least two discussion questions. One of you will need to post that material prior to your designated reporting date. You can upload the reading assignment directly to our site, or link to it, or go to the campus copy center and create hard copies for all your classmates.

These reports are worth up to 20 runs for each of you. Each reporter should be prepared to speak for 10 minutes. Your group is also responsible for administering the quiz and moderating discussion. You may post your remarks, prepare a powerpoint, speak from a script, or not - your choice. Just be relevant, interesting, and clear. Have fun teaching us about your text & topic!

1. Feb 9 - J'Ana, Derrick, Mason, Bethany - When Breath Becomes Air by Paul Kalinithi

2. Feb 14 - Conner, Nolton, Erika - Patient H.M.: A Story of Memory, Madness, and Family Secrets by Luke Dittrich

3. Feb 16 - Nick B., Nick C., Cameron - Bioethics for Beginners by Glenn McGee

4. Feb 21 - Jayla, Sophie, Heather, Anna - The Immortal Life of Henrietta Lacks by Rebecca Skloot

5. Feb 23 - Zoe - Clone: The Road to Dolly, and the Path Ahead by Gina Kolata 

6. Feb 28 - Tanner, Zachery, Roderick, Morgan - Wisdom of the Body How We Live by Sherwin Nuland

7. Mar 2 - Sydney, Moesha, Chris - The Case Against Perfection by Michael Sandel

Alternative Quiz #4

1. George Bernard Shaw described the medical relationship in his play, The Doctors's Dilemma, as a "conspiracy against the larity'. What does this mean? (p.80)

2. (T/F) Deciding what is in the best interest of the patient is ALWAYS straightforward? (p. 81)

3. What are the three key features of valid consent? (p.83)

4.  (T/F) No matter what, a doctor or health care professional is not allowed to disclose patient information. (p.87)

5. What is the medical terminology for the termination of pregnancy? (p. 88)

6. What is "in vitro" fertilization?  (p.92)

7. What is a designer baby? (p.96)

8. What does SCNT stand for? (p. 99)

9. What are cadavers and why are they relevant? (p. 109)

10. Name one of the books Campbell recomended for further reading and resources for this chapter.

DQ:

1. How do you feel about the concept behind designer babies?

A Clip from House for Discussion

House as a series is pretty great at showcasing all kinds of moral and ethical dilemmas that can come up in the medical field, and one that I think should be mentioned here is when one of the doctors in the show (Chase) has a patient who happens to be a dictator of an African country. This dictator has been charged with crimes against humanity, and is a pretty stereotypical evil character. While this man is in the hospital, Chase has an opportunity to murder him and make it appear like an accident. The ethical question here is: Do you kill the dictator? Or do you let him live so he can "fly back to his country and murder thousands of people?" (quote from the show).

This raises a few interesting questions. One of them is not restricted to the medical field, and it can be stated as "If you know someone is going to kill numerous innocent people, and the only way you can stop this person is by killing them, should you do it?" The other one, which is specifically medically related, "Do doctors have an obligation to treat their patients to the best of their ability, even if they believe their patient is despicable human (in their opinion)?"

Alternative Quiz Questions: Ch. 4 Clinical Ethics

1. Campbell states that the "first consideration of a health professional must always be the best interests and welfare of the patient -". Why is this seemingly obvious statement even stressed? (80)

2. What is the overall result of long-term care of severely mentally or physically compromised patients who cannot care for themselves and make their own treatment decisions? (86)

3. What is considered the strongest reason for stressing the importance of confidentiality? (87)

4. An individual who HIV positive refuses to inform a sexual partner of their diagnosis. This is an example of a breach to what principle? (88)

5. What are some of the numerous conceptual difficulties mentioned by Campbell under the mentality that the entity created at conception is a person due to genetic uniqueness? (89)

6. Name at least one of the ethical concerns raised by the possibilities of creating a child mentioned by Campbell. (93- 94)

7. What is the relation between the term "natural" and the term "person" and how does this perhaps  contradict the teachings of the catholic church? (94-95)

8. What is the therapeutic potential of of Somatic Cell Nuclear Transfer? (99)

9. What are the two concerns related to ethical issues revolving around individuals with mental illness? (101)

10. After accepting death as a _______________, and not merely as a __________________, the question of whether to withhold or withdraw treatment immediately arises. (105)

Optional Alternate Quiz for Chapter 4

1.      In the play by George Bernard Shaw, the medical relationship is seen as a ‘conspiracy against the laity’. What does he mean by this?(80)

2.      What are the 3 key  features of valid consent?(83)

3.      What is ‘tort’? How can a health care professional be guilty of it?(85)

4.      Which court case resulted in the general principle that confidentiality could be breached if there was a clear threat to an individual?(87-88)

5.      The Roman Catholic Church led some groups to describe abortion as… (89)

6.      The ___________ view is one that sees the fetus as the beginnings of a nascent human life, but still far short of individual human existence as a person. As it develops it has increasing significance. (90)

7.      What is a weak justification for wanting to get an abortion? (91)

8.      Through assisted reproduction, theoretically how many parents could a baby have? (93)

9.      What are considered the ‘building blocks’ of all organic tissues in regenerative medicine?(99)

10.  What is a traditional approach in delivering a ‘bad prognosis’? (103)