"My Opinion is... (8) Minor Abortion and Ethical Theories"Those readers of Knol may recognize me as the moderator of the Bioethics Discussion Blog which is now starting its 5th year. On the blog, I set the topics and await for my visitors to write their comments on the ethical issues described. Since I don't want to bias or direct my visitor's responses, I usually do not regularly express my own views on the topic. I thought it would be worthwhile using the format of Knol to let the readers set the topic and if I find that I have enough experience or knowledge to contribute to the topic, I would try. My experience is that of 50 years of medical practice and over 20 years of teaching first and second year medical students and participating in hospital clinical ethics committees.
I would welcome your questions about the ethics involved in medical education and medical practice. I will select to answer those questions that I feel I have some knowledge, experience and viewpoint to be of value to the questioner. I have to limit my responses to general issues which arise in the question and not to the specific cases presented to me. Making ethics decisions is based on facts. Some of the facts necessary are not immediately apparent. It is unlikely that any personal specific case presented to me by this Knol will provide sufficient facts for me to suggest a specific decision. (In a hospital ethics committee consultation, it may take an hour of reviewing the history and medical facts to provide the stakeholders with suggestions for ethical decisions.) I may use the topic suggestions by the readers here to put up as new threads on my bioethics blog.
I will number the Knols in sequence with one Knol for each topic. This is #1, the Question Knol. where the readers can post their questions about bioethics for me. Those questions which I feel I have the capacity (knowledge, understanding and viewpoint) to answer, I will post my answer on seperate Knols for each topic and for responses by the readers including my own responses to what they write. WRITE YOUR ORIGINAL QUESTION TO BE ANSWERED HERE. WRITE ANY COMMENTS PERTINENT TO A SUBJECT ON THE KNOL WHERE THE ANSWER IS PUBLISHED..
.Maurice.
I would welcome your questions about the ethics involved in medical education and medical practice. I will select to answer those questions that I feel I have some knowledge, experience and viewpoint to be of value to the questioner. I have to limit my responses to general issues which arise in the question and not to the specific cases presented to me. Making ethics decisions is based on facts. Some of the facts necessary are not immediately apparent. It is unlikely that any personal specific case presented to me by this Knol will provide sufficient facts for me to suggest a specific decision. (In a hospital ethics committee consultation, it may take an hour of reviewing the history and medical facts to provide the stakeholders with suggestions for ethical decisions.) I may use the topic suggestions by the readers here to put up as new threads on my bioethics blog.
I will number the Knols in sequence with one Knol for each topic. This is #1, the Question Knol. where the readers can post their questions about bioethics for me. Those questions which I feel I have the capacity (knowledge, understanding and viewpoint) to answer, I will post my answer on seperate Knols for each topic and for responses by the readers including my own responses to what they write. WRITE YOUR ORIGINAL QUESTION TO BE ANSWERED HERE. WRITE ANY COMMENTS PERTINENT TO A SUBJECT ON THE KNOL WHERE THE ANSWER IS PUBLISHED..
.Maurice.
Tiff1
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Using Ethical Theories
Based on ethical theories such as (utilitarian, Kantian etc.) which of them would be reasonable to think that Susan holds?
Was the doctor right for telling both susan and her mother at the same time?
Since both parties have two different answers how could he use the MORAL Model to help them come to an agreement?
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http://knol.google.c
for my response. ..Maurice.
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Ali
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Ethical Dilemma
Mrs. Gomez is a 92 year old Mexican American woman who presents to the ED with fatigue, palpitations, and intermittent chest pain. She us a first generation immigrant, speaks English well, lives alone since her husband died. She is accompanied by one of her daughters who lives nearby.
PE identifies atrial fibrillation, elevated pulse rate, elevated BP and abnormal lab values. After stabilization and a MI is R/O a medication review is done. Mrs. Gomez says she has been taking levothyroxine for many years for her low thyroid. She sometimes has problems remembering if she has taken it and so she “just takes another for good measure”. She is not sure how many times a day she actually takes it. “If one pill is good, then three or four are probably better”.
The daughter is horrified and says “that’s it, I work and cannot watch you every minute, you are going to a nursing home where you will be safe”. Mrs.Gomez begins to cry inconsolably and saying “no, no, no, how could you do this to me, your mother?”.
1. What moral principles (autonomy, beneficence, non-maleficence, justice, caring, veracity) are involved for whom?
2. What information might reduce the dilemma?
3. Is there an intervention that would lead to a resolution and be moral for the mother and the daughter?
4. Is culturally appropriate care an issue with this patient situation?
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Anonymous
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tests done without patients permission
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Krishan Maggon
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Organ Transplant and shortage of organs
It can be addressed by invoking "Presumed consent" and paying families
for the medical costs of the brain dead dead patient before harvesting organs.
Hospitals, surgeons and laboratories gain a lot of prestige and money doing organ transplants.
Why a poor person, who wants to make a new start in life,
not able to sell his kidney in the open to the hospital and provided medical care and follow up in case of any problems?
I had set up a new Bioethics knol (unpublished) to debate this issue'
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Christopher Harris
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Rewarding deep brain stimulation for human use
For the sake of argument, let's assume that the application for approval is submitted regarding either
1) An attempt to use rewarding deep brain stimulation to motivate physical exercise in a morbidly obese patient. Note that rewarding brain stimulation has long been an effective method for motivating behaviors such as physical exercise in experimental animals (Burgess et al, 1991; Garner et al, 1991), and that deep brain stimulation has already been used, unsuccessfully, in an attempt to reduce hunger in a morbidly obese patient (Hamani et al, 2008).
or
2) The case of one member of the research/surgical team wishing to serve as experimental subject. Note that researchers such as Kevin Warwick have already been granted permission to 'self-implant' on several occasions (Warwick et al, 2005).
References
Burgess et al (1991) Intracranial self-stimulation motivates treadmill running in rats. Journal of Applied Physiology 71(4), p1593-1597
Garner et al (1991) Intracranial self-stimulation motivates weight-lifting exercise in rats. Journal of Applied Physiology 71(4), p1627-1631
Hamani et al (2008) Memory enhancement induced by hypothalamic/fornix deep brain stimulation. Annals of Neurology 63(1), p119-23
Warwick K et al (2003) The application of implant technology for cybernetic systems. Archives of Neurology 60(10), p1369-1373
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Alex Tang MD
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Cardiac Death and Organ Harvesting
In recent years, there is a movement to harvest organs when the heart stops but brain function is still present. This is usually in patients that are severely ill and are going to die. This is termed "Non-Heart-Beating" or "Cardiac Death" organ donation. The University of Pittsburgh Medical Centre allocated 2 minutes after the heart stops before organ harvesting can begin. There is some uncertainty about this and the Institute of Medicine (IOM) extended the time to 5 minutes. However there have been documented cases of "autoresuscitation" i.e. the heart restarts after 10 minutes of no heart beats. The University of Zurich allows 10 minutes. This is a scary development because doctors are allowing patients to die so that organ harvesting can take place.
Dr Mark M Boucek reported the first heart transplants in three children after cardiac failure rather than brain death in August 14, 2008 issue of the New England Journal of Medicine. The transplants were done in Denver's Children Hospital in Denver. The time between the heart stops and organ harvesting is...75 seconds.
This is a scary development because the ends has justified the means. While it cannot be denied that there is a need for human organs, these organs must be harvested from patients who are already brain dead, not those allowed to die.
What do you think?
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Twister
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Organ Donation and the BMV
I recently took my fifteen year into the BMV/DMV to get her permit. As I stood at the counter with her, they asked her if she wanted to be an organ donor. I spoke up and said no. I will express my reasons why later. Then a month later when she went back in to get her actual license, I was not at the counter with her and they asked her again, without my input, and she said yes. So now she is an organ donor against my wishes and she is a minor. Why is the BMV allowed to do this to minors? I bet there are some surprised parents who have lost their teenagers in car crashes, when the organ donor companies show up at the hospital. I have heard that sometimes, they are so pushy that it puts a burden on families at a very hard time. Please let me know your thoughts on this.
Seashel2001@aol.com
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