Paper Topics Paper

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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

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Genetic Screening
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Human Genome Project

• Goal Map the entire human genome
• Limits
• 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?

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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

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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?

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A Brief Catalog of Ethical Concerns
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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?)

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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?

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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

10
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?

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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)

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Commercialization

• Patenting of genes and gene products
• Granting exclusive licenses for genetic tests and
  methods

13
Patenting Genes?

• Sounds ridiculous
• Probably 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

14
Exclusive Licenses

• May be a bigger threat
• Replaces scientific exchange with industrial
  secrecy
• Conflict of interest for scientists and
  universities
• Makes it difficult for practitioner to trust
  information from journals, etc. (informed consent)

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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 predictive
• Did new information get out fast enough, given
  companys financial interest?

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Eugenics

• Negative eugenics Prevent or treat genetic
  diseases
• Positive eugenics Improve or enhance function of
  future generations

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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

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Treatment vs. Enhancement
Therapy
Enhancement
0
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Childs Right to an Open Future

• In favor
• Protects childs exercise of developing autonomy
• Prevents parents from exploiting their children
  in the name of their own interests or those of
  the group

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Childs 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?

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Childs Right to an Open Future-- Opposed

• All parenting is an exercise in limiting a
  childs 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 childs future in some way

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Childs Right to an Open Future-- Opposed

• Being a child means not getting to choose
• Who your parents are
• What is your community of origin
• Your familys religious or philosophical
  allegiances
• Future choices cannot undo your roots

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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

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Genetics in its place

• Nazi Germany proved that if you want to do evil
  in the name of positive eugenics, you dont need
  newest genetic technologies
• McGee If you want to really mess up your kids
  you dont need gene therapy to do it
• Genetics not a special ethical category

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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