Artificial hearts show promising results

 According to an article written and discussed about on abc's Good Morning America program, the quality and effectiveness of artificial hearts are improving. Earlier this week (or two weeks ago), the first successful artificial heart transplant surgery was conducted on a patient who had advanced heart failure (Feng, 2012). As it was explained, there are some cases in which left ventricular assist devices may help a failing heart; in other situations, an artificial does better and acts as a bridge therapy (Feng, 2012). It kept the patient alive long enough to receive a donor heart five weeks later (Feng, 2012). 

Mechanical heart. Taken from http://www.msichicago.org/fileadmin/blog/msi/2012-03/mechanical_Heart.jpg

I believe that such a gateway organ would be very useful for many patients waiting on organs (we already know how I feel about this), and due to what I have witnessed as a nurse and as an avid reader of bio-ethical news, I think the transplant surgeries of the artificial hearts is completely ethical and moral. It is the right thing to do as a health practitioner to provide a patient who wishes for a transplant a better chance at receiving that transplant (keeping him or her alive long enough for that transplant to happen). And while I am not sure if the artificial heart was part machine or completely derived from stem cells, I find the surgery ethically moral. If anything, I would have deemed it unethical if the doctors and surgeons had access and knowledge of the artificial hearts and withheld that information from the patient who would have opted to go that route. The surgery saved the patient's life.

Reference:

Feng, C. (2012, June 27). With each operation, artificial hearts show more promise. Retrieved June 30, 2012, from http://abcnews.go.com/Health/artificial-hearts-show-promise/story?id=16656231

Is it okay to cheat?

An article from ScienceDaily caught my attention today. The article speaks about situations in which it is morally okay to cheat, lie, or forge signatures--particularly concerning high schoolers. According to the article, sometimes children lie because it will give them a higher rating of approval from their peers. The author used the example of Thomas, who takes the fall for breaking a chair and prevents the class as a whole from being punished. Although he lied about breaking the chair, he is praised by and looked up to by his peers (University of Zurich, 2012). The article also spoke about how pupils expect scrutiny from their teachers, and they behave inappropriately when the teachers fail to live up to their expectations. Here, the article provides the example of a teacher giving her attention elsewhere during an examination, rather than on the students. As far as the children are concerned, "If Miss can't be bothered to check, that's her problem; it's open season for cheating" (University of Zurich, 2012).

Taken from http://www.owensworld.com/sites/default/files/imagecache/Fullsize/pictures/expert-cheating.jpg

Part of the article caused me to question what constitutes as lying. If an individual does not ask for certain information and that information is withheld from him or her, is that lying? I finally concluded that the answer to that question, as the children in the article have, is no. It is not lying to withhold information from someone who has not asked for that particular information. However, it may be unethical to withhold that information if knowledge of the information may benefit the individual of interest in some way. As either a nurse or a doctor, there are situations that sometimes arise when results of a blood test arrive. For example, there are times that patients are HIV positive and have AIDS, but their spouse or loved ones do not know. They do not come asking the doctors because they do not suspect their loved ones have the disease, and if the patient with AIDS does not want his or her doctor to disclose it with the family, the doctor cannot. Here, the doctor does not lie to the patient's friends or family, because they have not asked. If the loved ones ever were to ask, however, it would be wrong for the doctor to state that the patient was negative. Instead, the doctor can let the family and friends know that he is not allowed to reveal that information, and could possibly suggest they ask the patients themselves.

There are a lot of touchy areas in medicine that have shades of grey in between. But as a doctor or nurse, what is morally and ethically right is based first for the benefit of the patient, just as for the school children, what is morally and ethically right is based on social settings and cues.



Reference:
University of Zurich (2012, June 28). Sometimes, cheating is allowed, study suggests. ScienceDaily. Retrieved June 29, 2012, from http://www.sciencedaily.com­ /releases/2012/06/120628145622.htm

Obama's health care law upheld by the highest court

I am happy to say that President Obama has scored yet again. After having to deal with being told that his presidency was unconstitutional (due to him not having a legitimate birth certificate because he wasn't an American--we all know what really stemmed that debate) he provided the Birthers and Donald Trump with his certificate of birth. And now, after being accused from various opponents that his health care reform law was unconstitutional, the highest court of the land we call America has upheld a 5-4 ruling stating that the law is constitutional (Liptak, 2012). I think Obama greatly summarizes what happened better than I ever could, so here's a link to the video of the speech he gave here.

As a nurse, someone who has gotten sick, and someone who has had close friends and relatives get sick, I know about the pit falls and loop holes of the old insurance system. On far too many occasions, so-called health insurance has done more harm than good to certain friends and family members. And there are those who do not have health insurance, which greatly worries me because those are the people who tend to need it the most. Luckily, no one in my immediate family has fallen so ill, and I thank God for that. But there have been situations where we were close to suffering at the hand of health insurance companies who agree to help you out, only to come up with a million and one excuses as to why they no longer can help you out once you need it.

The next question is: is it ethical? The answer to that, for me, is simple. 

President Obama. Taken from http://www.columbiadailyherald.com/sites/files/styles/large/public/article/243791_web_Obama-Health-Care-Leg_Ball_bds.jpg

Yes. Yes, the law is ethical, as it helps those that are in need and provides even more help and assistance for those who already have health insurance. Everyone's health should be protected and looked after, not just the rich. I do not care if that is just the way it has always been. As far as I am concerned, Mitt Romney's health is not more important than my health because that infers that his life is more important--is more valuable--than my own. But I know my worth. Do you?

Of course, that won't stop opponents from still claiming it is unconstitutional, just like proof of Obama's birth certificate has not hushed the Birthers. But I'm proud of Obama for this victory. And as my kids say, haters gon' hate.

Reference:

Liptak, A. (2012, June 28). Supreme court upholds health care law, 5-4, in victory for obama. The New York Times. Retrieved June 28, 2012, from www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html

Forced abortion of seven-month old baby--graphic

I was a bit disgusted to read about the enforcement of China's one-child policy from The New York Times a couple days ago. According to the article, a woman who was holding a seven-month-old fetus was forced by local officials to abort the baby (Wong, 2012). I feel as though I might as well call it a baby, because by 24 weeks, some fetuses can survive on their own. I have witnessed it as a nurse. The woman, Feng Jianmei, was reportedly abducted after not paying a $6,300 fine for the second pregnancy. When that failed to thwart her, she was taken into the hospital where they induced her. After the details of her ordeal were released to the public (after some trouble, I am sure), Chinese officials visited Ms. Feng and apologized (Wong, 2012).

Ms. Feng post-unwanted-induced abortion from http://www.allgirlsallowed.org/sites/default/files/Feng%20Jianmei%20Post-Abortion.jpg

This issue is a bit harder to comment on without delving into the politics surrounding China. Regardless, I believe the stunts pulled by the officials were horrendous and disrespectful to not only the mother and the father, but to the unborn baby. Contrary to my support for stem cell research, this baby was not killed/used for the purpose of research that would benefit the community, nor did the mother offer the baby for research. The baby was killed for (as far as I am concerned) no good reason. If there were disagreements concerning the birth of the child, there were other ways to address those concerns. Perhaps, instead of killing the child, the officials could have slapped Ms. Feng with a bill and deduce amounts from her or her husband's paycheck (they do that here with student loans when people refuse to pay, I know). Killing the baby was nothing more than a chance for the Chinese officials to show-off the power they had over Ms. Feng, and it was an inappropriate use of power.

Ms. Feng plans to have a second child if she gets her health back (Wong, 2012). I hope she has a third.

Reference:

Wong, E. (2012, June 26). Forced to abort, chinese woman under pressure. The New York Times. Retrieved June 27, 2012, from http://www.nytimes.com/2012/06/27/world/asia/chinese-family-in-forced-abortion-case-still-under-pressure.html?_r=1

Three-year-old burn victim healed from stem cells

 As I mentioned in an earlier blog entry, I support stem cell research. So I was delighted to read from The Washington Post that three-year-old Isabella "Pippie" Kruger benefited from the wonders of stem-cell research. According to the article, there was a cloned-skin transplant surgery done, which helped Pippie out after receiving burns on 80% of her body (Associated Press, 2012). During the recovery process, Pippie was reliant on feeding tubes and was completely sedated for a week to make sure that she kept still and would not tear her new skin (Associated Press, 2012). Pippie is likely to be discharged later on this week, which is great news.

Mother and the burn survivor, Isabella Kruger. Taken from http://www.washingtonpost.com/world/africa/3-year-old-south-african-burn-victim-who-received-cloned-skin-to-leave-hospital-soon/2012/06/26/gJQAKeFv4V_story.html

The question here is not whether or not stem cells are ethical. The question here is whether doing stem-cell based transplant surgery is ethical, which I think it is. If the stem cells are there and capable to do good, why not put them to us? And after seeing the disparities concerning live organ donor transplants for kidneys in a previous blog entry--something the average human has two of--I can only imagine (if skin were donate-able in the same fashion) the many people who would willingly donate their skin. 

Please, note the sarcasm.

I hope that other successful organs are grown from stem cells. Maybe then there would not be such huge disparities when it comes to those who are given spare organs. Then again, maybe a lack of organs is not the actual problem. Who knows?

Reference:

Associated Press. (2012, June 26). 3-year-old south african burn victim who received cloned skin to leave hospital soon. The Washington Post. Retrieved June 26, 2012, from http://www.washingtonpost.com/world/africa/3-year-old-south-african-burn-victim-who-received-cloned-skin-to-leave-hospital-soon/2012/06/26/gJQAKeFv4V_story.html

African Americans get the short end of the stick with organ donations, if they get any at all

Today I saw an article on CNN Health that spoke about the likeliness of African Americans to receive kidney donations. According to a study published by the American Journal of Kidney Diseases, African American patients that are waiting for a new organ are less likely to get an organ than non-blacks are (Bardis, 2012). Turns out the likeliness is 35% lower on average, but is known to be 76% lower in some cases (Bardis, 2012). This was not a study conducted overnight; the study surveyed 247,707 adults registered for first-time kidney transplants from 1995 to 2007. Despite the fact that African Americans have a higher prevalence of obesity and diabetes and make up more than one third of those waiting on living donor transplants, they are at lower odds of obtaining an organ transplant" (Bardis, 2012).

Taken from http://www.bevsmithtalks.com/clientfiles/image/100%20black%20men.jpg

It is obvious to me that the problem lies within racial disparities, and what helps constitute these racial disparities could not at all be addressed in this blog. That's a topic to have a whole other blog dedicated to it. But I will say that it is morally and ethically wrong for those in charge to discriminate against African Americans who are waiting for live donors. One thing I would like to ask is if this evidence is all circumstantial--maybe the organs are given on a first-come-first-serve basis. But I find it hard to believe that the first-come-first-serve basis was fairly applied to 813 African Americans out of the 5,771 living donor transplants performed in 2011 (Bardis, 2012). It is too coincidental to me, as is the inexplicable reason for why African Americans only make up 13 or 14% (maybe even 15% now) of the total U.S. population while they make up over 50% of the prison population. But that's a blog entry for another day...on a blog dedicated to race, perhaps, and not bio-ethics.

Reference:

Bardis, O. (2012, June 25). African-americans less likely to receive kidney donation, study shows. Retrieved June 25, 2012, from http://www.cnn.com/2012/06/25/health/african-american-kidney-donation/index.html

Death with dignity act = dignified suicide

The topic of euthanasia and physician is very controversial in my household, something I do not know what to feel about it. Reading this article from However, The National Post may have helped me  get some things clear in my mind. The article talks about the state of Oregon and the Death With Dignity Act, which protects patients, doctors, and pharmacists who adhere to some of the many rules from criminal prosecution (Lewis, 2012). The Death With Dignity Act differs from euthanasia, which is punishable by law and illegal. The overriding difference between the two is that the drug must be self-administered (Lewis, 2012).  Also, the actual act of dying is not done on whim. The patient must make a written request signed in the presence of  two witnesses and must take two oral requests by his or her doctor that are separated by 15 days (Lewis, 2012).

Taken from http://www.pewforum.org/uploadedImages/Topics/Issues/Science_and_Bioethics/oregon_large%281%29.jpg

Do I believe that such an act is ethical? Yes, but I say so with reservation. Those who are old enough and understand the concept of death and view it as a blessing in comparison to the constant unbearable pain they suffer should have a means of coping with that pain. Moreover, those who wish to die with dignity should be allowed the right to do so. It does not make much sense to keep a person alive that wants to die. But while I would like to believe that the act was spurned from good intentions to put those out of their unbearable misery, the truth is that there are many who will abuse the provisions of the act and cause harm to those most vulnerable. I would love to argue that life insurance or death insurance is a good call; it gives some form of compensation to those who have lost a loved one. But people abuse that every day, in the same fashion I am sure Oregon's Death With Dignity Act is subject to be abused.

I will probably have more to say about this, but this is all I can coherently muster right now.

Reference:

Lewis, C. (2012, June 22). What oregon’s experience can teach us about assisted suicide. National Post. Retrieved June 22, 2012, from http://news.nationalpost.com/2012/06/22/what-oregons-experience-can-teach-us-about-assisted-suicide/

To pull the plug or not to pull the plug?

I read an article today on the CNN website which spoke about how a family has decided to wait for their son to wake up, after he was trapped underground without oxygen for 15 to 20 minuted when a sand tunnel collapsed on him while he was at a beach in 2011 (Park & Wilson, 2012). He has remained in a vegetative state for a year, but his parents have brought him home and hope for him to awake from the vegetative state. Bringing their son, Ryan Buchanan, home was not the cheapest alternative, but it is an alternative that parents are often willing to take (Park & Wilson, 2012).

Ryan Buchanan. Taken from http://i2.cdn.turner.com/cnn/dam/assets/120503015738-buchanan-ryan-bed-horizontal-gallery.jpg

 As a parent, it is an alternative I know I would probably be tempted to take. Questions of concern may arise about whether it is ethically or morally okay to keep Ryan alive on equipment that the government or the people in Ryan's community  are paying for. Right now, the best I can offer is yes, as long as it is not an excessive amount of years (excessive meaning ten or more years). I say that with a hint of reservation because I am sure somewhere and somehow by the Grace of God, a person in a vegetative state for the past 10 or more years has awoken. But I believe waiting for an individual to awake is morally and ethically sound on the basis of treating others the way you would want to be treated. I can only imagine what the family and friends of Ryan went through, and I'm sure it was not an easy decision for the family to decide to keep him alive, despite his vegetative state. I just think about if I were to be in that situation, (I pray and thank God for shielding me so far) the last thing I would want to worry (or pretend to care) about are what other people who have no idea what I am going through tell me what they think is best. I think whatever the outcome--keeping a person alive on a machine or pulling the plug immediately--should be followed and regarded as ethical, as long as it is done according to the wishes of the family (if the person currently in a vegetative state has not made known any of their desires).

Reference:

Park, M., & Wilson, J. (2012, June 16). Waiting for our son to wake up. Retrieved June 19, 2012, from http://www.cnn.com/2012/06/16/health/buchanan-home-child-care/index.html

Quick medical access saving lives

Today, I read from The New York Times about the move toward electronically maintained medical records. Though this was published just yesterday, I know the hospital I work at in New York has already moved toward that direction. As noted by Freudenheim, it would take weeks to find out if an infection was becoming more common than usual, or note if an outbreak was occurring (2012). Medical centers, private or public, were disconnected from each other--I can attest to that. And I can also attest to the fact that this technology helps officials faced with events of public health significance to know what they may be dealing with sooner (Freudenheim, 2012).

Taken from http://www.jofwidata.com/images/database-design-development.jpg

While I have witnessed its effectiveness, I also know of the valid concerns about electronically stored data. The information could be hacked into, which was my initial worry. But the same thing holds for any piece of important information in this day and age. While I would probably feel angry and violated that a stranger has accessed and/or released all my medical information, I think the pros of having quick access to my medical files in the case of an emergency far outweigh the cons, which involve a momentary feeling of violation. Perhaps I am more open to this idea because I have had to deal with identity theft before, so I may be a little more mentally (and legally) prepared when it comes to theft concerning identity or a breach of my personal files. (I also suspect that perhaps people are most protective about their ailments because of the biases surrounding certain illness as pre-existing conditions. But under Obama's health care plan, I think pre-existing conditions can no longer harm an individual in regards to health insurance, so maybe less poeple will worry about their medical files being hacked for that reason. I digress.)

When it comes to the intent and purpose of the quick access to medical care, seems to me that it is for ethical and moral reasons. It makes me happy to see the way technology and current times can mix with traditional medical practices. 

Reference:

Freudenheim, M. (2012, June 18). Fast access to records helps fight epidemics. The New York Times. Retrieved June 18, 2012, from http://www.nytimes.com/2012/06/19/health/states-using-electronic-medical-records-to-track-epidemics.html?_r=1

Respect for elders

According to an article written in The Telegraph, doctors, nurses, and health carers will now face legal punishment for not taking care of or considering the well-being and dignity of the elderly (Kirkup & Smith, 2012). The law is supposed to help ensure that health care workers have the right attitude in mind when they take care of the elderly (Kirkup & Smith, 2012).

Taken from http://images.sciencedaily.com/2008/04/080416110114-large.jpg

I find this both a moral and ethical decision on the government's part, one that I fully support. It is wrong and unjust to deny particular patients of interest simply based on the grounds of their age. As a healthcare practitioner, it is not my job to dictate who I think is worthy of any help I can offer. It is my job as a nurse or healthcare provider to ensure that those who need medical help and attention receive that medical help or attention. I was not even aware that something like this could even happen to anyone. What's next: are doctors going to start denying care for patients that are black, gay, or have differing political views? At this rate, there will always be a reason to make someone ineligible for something if you are in power and do not like them (whomever them may be) enough. This really has me shocked. In my culture, the elderly are looked up to and respected, most times even revered. But it seems like in the U.S. (with reported elderly abuse in nursing homes) and now also in Britain that the elderly are not nearly as respected as I was brought up to respect them. Maybe I will look more into the matter.

Reference:

Kirkup, J., & Smith, R. (2012, June 11). Doctors face ban on denying treatment to elderly. The Telegraph. Retrieved June 17, 2012 from http://www.telegraph.co.uk/health/healthnews/9325667/Doctors-face-ban-on-denying-treatment-to-elderly.html

New public stem-cell lines available

According to this article from ScienceDaily, there has been the arrival of six new embryonic stem cell lines from the University of Michigan. They have just been placed on the U.S. National Institutes of Health's registry and are now ready and available for federally-funded research (University of Michigan Health System, 2012). Now the university has a total of eight cell lines in the registry that carry mutations for diseases involving hemophelia B, Huntington's disease, and hypertrophic cardiomyopathy (University of Michigan Health System, 2012). With cells like these in the registry, research can be done to study the origins of these diseases and more, possibly shedding light on cures for these diseases.

Taken from http://www.provost.duke.edu/images/Research.jpg

I think it is great that these stem cell lines have been discovered and placed in the registry for other research facilities to make use of. While we may not have yet discussed stem cell research in class yet, I do have my own views on the subject and I believe in the potential stem cell research offers. Stem cell research becomes unethical in my eyes when the cells are not used or treated with care and respect. The same holds if the cells used in the research were not intended for stem cell research. As long as the stem cells are treated with respect--and especially if the cells were donated for the use of research--why not proceed with ethical studies that may provide great results?


Reference:
University of Michigan Health System (2012, June 14). Six new stem cell lines now publicly available. ScienceDaily. Retrieved June 16, 2012, from http://www.sciencedaily.com­ /releases/2012/06/120614182600.htm

Drug trials in developing countries raise questions

This article by thegaurdian highlights certain information that were already known (at least to me). The information that gets the most emphasis is that concerning the trials of already licensed medicines that are carried out to increase sales instead of to improve the drug (Boseley, 2012). Questions are now being raised about the usefulness and real purpose of drug trials for me-too drugs (Boseley, 2012), drugs that copy the make-up of already approved and marketed drugs.

Taken from http://www.riskmanagementmonitor.com/wp-content/uploads/2011/01/pharmaceuticals.jpg

The trials for the me-too drugs is unethical and a waste of time. Well, maybe it is not a complete waste of time because it allows for drug companies to competitively price their drugs (hopefully making it cheaper for consumers/patients to buy). But I do believe that a focus on drug trials of this sort take away research and potential drug trials that could actually help cure current incurable diseases. Drug research should be done to counter attack the diseases that currently have no true cure. But it is like a business out there in the real world. A company may spend millions of dollars conducting a research experiment that will yield no results, but they need (and also want) money. So instead of focusing on the next cure for cancer, companies spend their time making me-too drugs that have been on the market and will sell well. This drives researchers into research to make money, rather than driving them into research to find actual cures, like what used to be done in the past.

I guess it can be argued that perhaps stem cells are the new line of hopeful defense against this battle to find a cure for an incurable disease. Who knows.

Reference:

Boseley, S. (2012, June 12). Doctors raise questions over drug trials in developing countries. Retrieved June 15, 2012, from http://www.guardian.co.uk/business/2012/jun/12/doctors-raise-questions-drug-trials

Testosterone testing for women?

I saw an article today from ScienceDaily that I do not know how I feel about. There has been some discussion concerning the policies of Olympic testing of testosterone levels in some women  competitors. Controversy arose concerning competitor Caster Semenya, who ended up winning a gold metal in the women's 800 meters at the 2009 World Championships. According to the article, she was forced to undergo many tests that undoubtedly put her through much stress, and may even have caused her to question her identity (Stanford University Medical Center, 2012). What drove the testing were the other competitor's complaints that Semenya was "too masculine" and that those kinds of people should not run with them because they are like men" (Stanford University Medical Center, 2012). To my pleasure, as well as Semenya's I presume, she was eligible to compete as a woman and kept the gold metal. But due to the controversy, the IAAF has issued rules and policies to adhere if a female athlete's testosterone levels are unusually high. If that is the case for a contestant, they must somehow lower their levels in order to compete.

Semenya. Taken from http://www.stinkypalace.com/img/misc/caster-semenya/caster-semenya01.jpg

While the other women were angry for their seemingly disadvantaged state, it was not right to discriminate against Semenya for her physical attributes, and cause her to undergo many tests. Nor is it right to put a cap on how much testosterone is allowed in a woman for her to be considered a woman. This, I am sure, will bring much debate amongst the scientific community: what makes a woman a woman? Surely, low testosterone levels should not be the determining factor. Moreover, one could argue that the other competitors were simply not prepared enough to be considered women athletes. As long as Semenya has not injected herself with testosterone, she should not be punished for her mastery of her ability. After all, people who excel in a sport are not told they cannot play because of their biological make-up. Good basketball players that are tall should not (and are not) told to lower their height so that they are of average height before they can play, and the same thought process behind that tolerance should be used here. I am disappointed to see that it is not.


Reference:
Stanford University Medical Center (2012, June 13). Proposed testosterone testing of some female Olympians challenged. ScienceDaily. Retrieved June 14, 2012, from http://www.sciencedaily.com­ /releases/2012/06/120613153333.htm