Woman Given Windpipe Created in Laboratory

This case, considered a "milestone in medicine," discusses a woman who was given a new windpipe consisting of tissues from her own stem cells. Part of the 30-year-old's trachea needed to be replaced after undergoing a severe lung collapse, in order for her to live any sort of normal life in the future. Conventionally, the only option was removal of her lung so she and her doctors decided on the stem cell surgery, even though still a controversial option. Her team of doctors decided to replace the woman's lower trachea and bronchial tube to her left lung with a lab-grown airway. This procedure could signify the beginning of a new hope for patients with serious illnesses. With more and more successful stem cell surgeries, the process is starting to become more and more accepted popularly and in the medical world. It's so interesting to me that doctors and scientists can work together to basically strip down the trachea of a deceased person and turn the collagen into a working organ for a living person. It's truly mind blowing what lengths we can go to these days!

Should Kidney Donors be Reimbursed?

I recently read another interesting article regarding kidney donation. The November 8th article takes place in Singapore and discusses the option of paying donors for giving away their kidneys. A committee consisting of 18 members was put together to discuss the matter, and all agreed that "comprehensive reimbursement" was appropriate. This would include a 5 to 6-figure sum to take care of all related costs such as transport and medical costs and follow-up care. They believe that these costs are legitimate and do not view it as incentive or "paying people" to donate their organs. They believe that taking greater efforts to get people to donate kidneys will decrease the mortality in people who need kidneys, which seems like a valid move to make. I think that while this seems like a good idea at first, it might cause a similar controversy to the surrogate mother issue in that people may just go donate organs for a few extra bucks. I think it would make the most sense to not necessarily pay the donors extra, but only pay for all of their medical expenses so it wouldn't be of any extra cost to them (other than time and the stress of a surgery, etc.) It;s an interesting case...

http://www.straitstimes.com/Breaking%2BNews/Singapore/Story/STIStory_299838.html

Ethics of Paid Kidney Donations

This past October a conference was held in Karachi, Pakistan where experts from across the world gathered to discuss the ethics of paid kidney donations. Recent research has shown that the rate of survival of the recipient is improved if a kidney donation comes from a living donor, and that the procedure may have better results if the transplantation is performed before the kidney actually shuts down. India's representative believed that equal rights were not practiced in their culture, and that some people were cheated, "forced" to sell their organs due to poverty. A conclusion was reached that there is a need for increased awareness programmes and inviting more volunteer donors to partake at their will. In some countries, such as the Phillipines, donating kidneys to foreigners is illegal and financial profits by sale of human body parts is prohibited as well. I think this is an interesting topic because it is so relevant in today's medical world. It is difficult because I cannot see many people just volunteering to donate their kidney to a stranger. I think I would be more inclined, or even inclined to think about it at all, only if someone very close to me needed the kidney to live. The question remains; is it ethical to pay someone to donate their kidney or other organs?

http://www.dailytimes.com.pk/default.asp?page=2008%5C10%5C27%5Cstory_27-10-2008_pg7_24

Surrogate baby stuck in legal limbo

I read an interesting article from CNN.com regarding a surrogate baby whose adoptive parents divorced before she was born, and is now caught in so-called "legal limbo." Surrogacy was legalized in India about 6 years ago, and today women are carrying babies for others for up to 30,000 dollars. It is a very sad situation, since women are so poor that they make a "living" by undergoing a pregnancy for an infertile woman who wants a child. The process has been nicknamed"wombs for rent" by critics, and it is very uncertain where babies will end up in unique cases such as this. It's tricky because if the adoptive parents say they do not the baby, and the birth-mother of the baby never wanted the baby in the first place, whose care is the child really in? This particular child had a father and grandmother who desperately wanted to take care of her, but they couldn't get her home because in order to get a passport for the baby, the mother must be present. In this case, neither the birth mother nor the mother who had originally sought the child wanted to be involved. An advocate for the Supreme Court in India stated, "I think obviously India owes an obligation to speed up the legal and judicial process so that the child is able to travel as soon as possible." This issue needs to reach a consensus before hundreds of other children have nowhere to be placed after birth. Adoptive parents need to take full responsibility of their choices, even if unforeseen situations arise in the process. I don't think the surrogate mother should ever be put in a situation where she is forced to care for a baby that she had fully intended on giving up ever since conception.

Old people with dementia have a duty to die ??

I thought the article about Baroness Warnock's opinion on people with dementia was somewhat shocking. It seems downright ignorant and disrespectful to brush these people aside as if they don't deserve to live just as much as the rest of us do. I believe that if someone who has a terminal condition (i.e. has no more than 6 months or so to live) is truly suffering and consciously chooses to end their misery, then it is their right to do so. But, in most cases, people living with dimentia are not suffering to a debilitating extent and are fully capable of living rewarding and fulfilling lives. I don't think it would be morally ethical to "push" someone toward physician-assisted suicide, or sway their personal opinion in any way. It is very interesting that an influential figure has such a strong and open opinion toward consciously killing people before their actual time to go arrives. It minimizes the self-worth and autonomy of people suffering with the disease, as well as their families.

Do Doctors Really Follow Codes of Ethics?

There is an interesting article posted on "in the news" on blackboard, discussing codes of ethics and different cultures' use of them. Apparently, few doctors worldwide actually abide by their country's codes of ethics and many do not feel that they have that large of an influence on their practice. It's scary to hear this because if there is no standard to follow when practicing medicine, what are these doctors actually going by? Their gut? The influence of other doctors? What the patient wants/what the family wants? Who knows! The article points out that doctors do know that codes of ethics exist, but they often still fail to refer to them. Potentially, they are not effective in real-life practice, but why, then, has no one said anything? Why have they not been amended to fit the standards of today's technology and healthcare? The article goes on to discuss different cultural values and what or whom is ranked as a top priority for doctors. In the US, the individual patient is viewed as his or her own entity, entitled to make 100% of their own decisions in any situation. Patient autonomy is placed at very high value among all medical professionals (or at least, should be). In contrast, many other countries feel that the family should make important decisions for the patient. The article says, "A Confucian doctor practicing in Canada may speak to the family instead on the individual," and goes on to explain that a concept we (in the US) may find unethical is completely acceptable in many other societies. Abortion, for example, is accepted in other cultures because they believe that a child doesn't take their first breath until they are born. It is very interesting to read about the values and norms in other countries/cultures and comparing them with the underlying beliefs and perspectives in the US.

Psychological Association's Ethics Code Being Broken?

The American Psychological Association's code of ethics states that "Psychologists strive to benefit those with whom they work and take care to do no harm." An interesting article from the Boston Globe questions if psychologists assisting interrogation at Guantanamo Bay are potentially breaking that promise. The camp has been known to torture detainees and use controversial methods of punishment such as depriving them of sleep along with degrading them through a number of other treatments. Because of this, many professionals are openly against all psychologists assisting in anything to do with the camp. Some have blamed the APA for not "taking a firmer stance and punishing association members who have helped interrogators," and in the soon-to-come vote for new leadership, members are anxious to see how the new president handles the situation. Many hope to end all partnerships with Guantanamo in the near future and enforce a resolution to ban psychologists from working in such facilities. I found this article interesting because it discusses a professional association's code of ethics and how certain statements may be interpreted differently depending on the party reading it. To some, they may believe they are helping by assisting in interrogating prisoners. On the other hand, it seems somewhat barbaric to resort to torturous methods of punishment. Afterall, the conditions at Guantanamo Bay are enough of a punishment alone, and the detainees are still people at the end of the day. They too have the right to live life without being put intentionally in harm's way.

http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2008/08/30/psychologists_and_torture/