Category: Bioethics

I’ve been having on-going conversations with my sister and several friends, over the past couple of weeks, about the lengths people will go to in caring for a pet. A lot of our conversation has centered around chemo for dogs, driving hours to see vet specialists, and my own 17 year old cocker spaniel, who is getting to the point where we’re having to worry about his quality of life versus our selfish desires to have him with us. The case of Barbaro has been an especially interesting story to follow, in light of these conversations.

How far is too far? The owner’s of this race horse estimate that they probably spent nearly half a million dollars on eight months of medical care for this horse, before finally conceding defeat and having him put to sleep. That’s a lot of money, and while I am, and always have been, crazymad about animals, I have to wonder at the cost – just like I wonder at the literal cost of kitty chemo, and the quality cost of having to carry an old cocker spaniel around because his arthritis prevents him from taking the stairs.

As I mentioned, I’ve been doing some indexing work. It’s a big job, and a bit overwhelming – not just in size, but content. Bioethics is not a terribly happy field, and reading hundreds of articles, one on top of another, about death and murder and lying and all of the worst traits of humanity over and again gets a bit, well, depressing.

Add in that I’m doing this work alone in my apartment, it’s very cold out, dark, and generally winter, and it’s probably not a surprise that I voluntarily spent my weekend in PHP hell, instead.

But that said, it’s not really a surprise that, say, a teenage boy in the Midwest repeatedly beat his 6-months pregnant girlfriend in the stomach with a souvenier baseball bat – at her request. Because they were trying to get her to miscarry, as that was easier than getting an abortion, and didn’t involve telling her parents (which this state would have required). This is the kind of reality I’ve lived in since working for Planned Parenthood, and I’ve never been terribly naive about general human nature at large.

So on one hand, it’s surprising that with my cynical view of society, I find this so surprising, but I do. Maybe like just about everyone else, the AMA’s Dr. Kildare depiction of doctors imprinted on me at a young age, but I just find it shocking that anyone would be alright putting their name on reports assuring that a drug – an anti-depressant – is safe for a population group, when in reality it’s tripling the risk of suicide! How do you live with yourself, signing your name to these ghost-written reports? How do sleep at night, knowing that your expertise is being used, knowingly, to drive sales at the expense of people’s health, their lives?

I mean, we’re talking a systematic effort to obscure, obfuscate, manipulate data, and outright lie in order to completely misrepresent an anti-depressants effectiveness in teenagers. It’s not just doctors allowing themselves to be bought, it’s the people doing the buying, and the journals doing the publishing. Where is the mea culpa from the journals propagating this misinformation? Shouldn’t they be responsible enough to demand the data, and not just take the word of a researcher? Haven’t we learned anything from the numerous incidents of academic fraud in the last couple of years?

I don’t know, I guess I’m just horrified that people can justify large scale harm like this. I can understand the fear and terror and the mentality that leads scared teenagers to make a very bad personal decision, but this is not the same category. This is not a family squabble over end-of-life care dragged onto the political stage, this is multiple, if not hundreds, of people, all choosing complacency over the safety and health of the public.

John Cloud gets in a delightful pun in his Time article on gay sheep and the research being done in Oregon. The furor erupted a couple of weeks ago, with the predictable sides bleeting (sorry) their usual POVs – Limbaugh and company crowing that gay folk now have a reason to oppose abortion, and celebrating the potential end of gayness across the land, while the other side (helmed by Martina Navratilova) condemned the research as homophobes murdering gayness wherever they find it.The research involved looking at the brains of straight and gay male sheep, trying to determine if hormones could affect attraction. The sheep were slaughtered to examine the brains (mmm brains), and if anything, the ultimate research shows that there are definite brain variances between straight and gay sheep. Extrapolation, of course, is that the same would be true in humans.

Cloud, however, takes a very interesting position on the idea of a hormone patch (or other method of insuring a pregnant woman gets the proper hormone bath to insure a straight baby): let them. Let the bigots and homophobes have the straight babies they want, and let the gay children grow up in households where they won’t have to deal with that. Cloud’s probably right in the assumption that not all prospective parents would care if their child was gay or straight, instead more concerned about things like five fingers and toes, and the ability to breathe and nurse at birth.

The assumption seems to be, among advocates on both sides, that people would automatically choose to eliminate gayness. But Cloud’s position raises the interesting question of if this is necessarily the case, or if we’re seeing the insecurities and fears gay-rights advocates, in the face of a threat to there being others like them.

I think Cloud’s right – I think there are more than enough people out there who aren’t going to try to modify at least that potential aspect of their children. But maybe I’m just being optimistic… or just wanted the chance to use ewegenics in a post. Tough call.

My initial response to this article is something along the lines of “no matter how crazy a religion seems to you, there’s always one crazier…” but in truth, that’s not terribly helpful (and I know it – I’m just sans coffee so far this morning, and that’s never a good thing). In thinking further on it, my objection to the entire concept of religious exemptions for newborn blood screens comes from the fact that many of the costs that are incurred from having one of the treatable diseases that are screened forAnd I do want to stress that the newborn screening really should be only for treatable diseases. Frankly, I’d hope that any parent would opt out of, say, testing for Huntington’s – why in the world would you want a death sentence hanging over your head for your entire life? Newborn screening should be for treatable diseases and disorders, nothing more. in these tests are past on to society.

Granted, I have no firm statistics for that belief, but I’m pretty sure they’re out there. Likewise, I’m pretty sure that the families objecting to these screenings – the ones with a bakers dozen of children (or close to it) – are the ones that can’t afford to have a child disabled by phenylketonuria or other treatable genetic deficiencies.

So what happens when someone opts out of these newborn screenings, and then later on finds out their kid is afflicted with one of the treatable diseases that are screened for? Can we really punish the child for the parents mistakes, not treating it because of the decisions the parents made? No, we can’t – there’s nothing moral or right about that decision. We don’t punish children for their parents stupidity, no matter how tempting it might be. So we get an added strain on social resources, a burden that doesn’t have to exist or be there, simply because the parents didn’t want to.

This seems, in a word, broken.

Then again, I don’t believe in religious exemptions for vaccinations, either. Public health triumphs that of the individual, or at least that’s my inclination at the moment (ask me again at the end of the semester – my public health ethics class might change my mind).

But beyond all that, why are we allowing parents to make bad medical decisions for their children? There are plenty of states that say “that’s nice that it’s your religion, but your tot is too young to be deciding what religion they want to follow, so no faith healing for meningitis, thanks – get thine child to thee hospital!” Isn’t the basic idea that parents need to keep the kid alive until the kid is old enough to make their own decisions? Shouldn’t this equally apply to newborn screenings, that the parents should be required to know if they need to put their kid on a special diet to prevent mental deficiencies that could be avoided through proper nutrition? Doesn’t a child have the right to a healthy life from birth, not just when sickness occurs?