Paper Topics (Paper #1) zPAS/VAE 8 zAbortion 3 zFemale genital “mutilation” 2 zDrugs for...
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Transcript of Paper Topics (Paper #1) zPAS/VAE 8 zAbortion 3 zFemale genital “mutilation” 2 zDrugs for...
Paper Topics (Paper #1)
PAS/VAE 8 Abortion 3 Female genital
“mutilation” 2 Drugs for behavioral
disorders in children Managed care &
patient advocacy Cloning- organ farms Parental
responsibility
Determining death Animal
experimentation Conjoined twins Religious refusal Terminal sedation Care of neonates Genetics Stem cell research Advance directives
Genetic Screening
Human Genome Project
Goal: Map the entire human genomeLimits
Map = static Genome = dynamic; constantly
interacting with other parts of itself and with the chemical environment
How many humans have to be sampled to arrive at the human genome?
Genetic Determinism
Idea that genes mostly or completely determine who we are and how we behave
Best scientific evidence: complex continuous interaction between genes and environment
Less an explicit position than a trap one falls into when not thinking carefully
Problem with Genome
Early ability to screen for genetic defects or risk factors
Much later ability to intervene to fix those factors (if ever)
How good is a screening test with which no treatment is associated?
A Brief Catalog of Ethical Concerns
Privacy
Conceal genetic info from: Employers? Insurance companies? Other members of family?
Would knowing prenatal risk lead to inevitable social coercion to prevent birth of “expensive” babies? (or demand that individual pay for care?)
Safety
Genetic technology may be experimental and relatively untested
When is it acceptable to attempt first human application?
Ethical to experiment on future child without its consent?
Justice
Genetic screening and technologies likely to be very costly
Either would add greatly to costs of health care in US…
Or would worsen two-tier system leaving “lower class” without access Example: Drug to raise IQ by 20 points
Eco-Ethics
Ecological risks of “messing around” with genetic material and genetic diversity
Probably mostly applies to agricultural uses which are currently little regulated
How rational is European distrust of genetically engineered food products? Is genetic engineering really different from
selective breeding?
Somatic vs. Germ Cells
Somatic manipulation: affects only one individual
Germ line manipulation: in theory affects a complete family tree indefinitely into future
Germ line therapy seems more intrusive and invasive re: the human gene pool (but is a “better fix”)
Commercialization
Patenting of genes and gene products
Granting exclusive licenses for genetic tests and methods
Patenting Genes?
Sounds ridiculousProbably not a great threat
Patenting gives one exclusionary rights (not any positive rights)
Patenting assures public access to information
Cannot patent your gene or your genome
Exclusive Licenses
May be a bigger threatReplaces scientific exchange with
industrial secrecyConflict of interest for scientists and
universitiesMakes it difficult for practitioner to
trust information from journals, etc. (informed consent)
Licenses: Example
Brca1 gene: 86% risk of breast cancer if a relative has disease
Based on this test, some women had preventive mastectomies
Now thought to be only 40% predictiveDid new information get out fast
enough, given company’s financial interest?
Eugenics
Negative eugenics: Prevent or treat genetic diseases
Positive eugenics: Improve or enhance function of future generations
Eugenics (cont.)
Usually argue negative eugenics is defensible, positive is not (due to who gets to define “enhancement”)
Recent criticisms: There may be no hard and fast line between remedying a defect and “enhancement”
Treatment vs. Enhancement
0
Therapy Enhancement
Child’s Right to an Open Future
In favor: Protects child’s exercise of
developing autonomy Prevents parents from exploiting
their children in the name of their own interests or those of the group
Child’s Right to an Open Future
Opposed: Idealizes a picture of a child as a future
chooser At some time of full maturity, looks
around among communities and makes a free choice as to where to live
Is this a coherent, meaningful picture of a child?
Child’s Right to an Open Future-- OpposedAll “parenting” is an exercise in limiting
a child’s future Doing one thing always means you did not
do something else (opportunity costs) Doing something else would have provided
child with some additional future choice Cannot teach values, beliefs, moral rules
without limiting child’s future in some way
Child’s Right to an Open Future-- OpposedBeing a child means not getting to
choose Who your parents are What is your community of origin Your family’s religious or philosophical
allegiancesFuture choices cannot undo your
“roots”
Against Exploiting Children
All good parenting means closing off some futures
One way parents can exploit their children is to close off futures
No easy formula to distinguish good and bad parenting
Hence cases like Old Order Amish & schools are tough cases
Genetics in its place
Nazi Germany proved that if you want to do evil in the name of positive eugenics, you don’t need newest genetic technologies
McGee: If you want to really mess up your kids you don’t need gene therapy to do it
Genetics not a special ethical category
Disabilities perspectives
J. Andre: Much of ethical thinking and moral development is “learning to see”
Typically we are blind to the many ways our society disadvantages and discriminates against persons with disabilities
Ethical thinking, at least, should not promote more blindness